Individual provider Active NPI

Vanessa Laquinte Neal, MD

  • Pediatrics Physician
  • San Clemente, CA
National Provider Identifier
1396945770
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A104294 Issued in CA
Practice address
3553 Camino Mira Costa
San Clemente, CA 92672-3512
Phone
(949) 200-7737
Fax
(949) 336-1949
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 0116016592 VA
Pediatrics Physician 208000000X A104294 CA Primary

Addresses

Primary practice location

3553 Camino Mira Costa
San Clemente, CA 92672-3512

Mailing address

3553 Camino Mira Costa Ste D
San Clemente, CA 92672-3512
Phone (949) 200-7737

Other names 1

  • Vanessa Laquinte Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0116016592VAMDSpecialist
A104294CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vanessa Neal Pediatrics Current Accepting new patients

Locations

3553 Camino Mira Costa
Ste D
San Clemente, CA 92672
Phone (949) 200-7737

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1396945770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 CAMINO MIRA COSTA STE D",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723512",
            "telephone_number": "949-200-7737",
            "fax_number": "949-336-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3553 CAMINO MIRA COSTA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723512",
            "telephone_number": "949-200-7737",
            "fax_number": "949-336-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "VANESSA",
        "middle_name": "LAQUINTE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0116016592",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A104294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "LAQUINTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.