Provider Demographics
NPI:1326636549
Name:REYES, MONIQUE BRIGETTE (PA)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:BRIGETTE
Last Name:REYES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1950 SUNNY CREST DR STE 2300
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3644
Mailing Address - Country:US
Mailing Address - Phone:714-446-5080
Mailing Address - Fax:714-446-5465
Practice Address - Street 1:1950 SUNNY CREST DR STE 2300
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3644
Practice Address - Country:US
Practice Address - Phone:714-446-5080
Practice Address - Fax:714-446-5465
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA60842363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant