Randy Reyes, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95013722 Issued in CA

Practice address

683 Lomas Santa Fe Dr
Solana Beach, CA 92075-1412

Phone

(858) 755-6697

NPI assigned

Jun 29, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1962029637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7147 CELOME WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921294546",
            "telephone_number": "858-603-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 LOMAS SANTA FE DR",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920751412",
            "telephone_number": "858-755-6697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18370 Burbank Blvd Ste 412",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913562844",
            "country_code": "US",
            "telephone_number": "818-506-3384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "RANDY",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-29",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013722",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013722",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rich Hycner, PH.D.
• Rise Physical Therapy Inc
• Shacy Rivera, ND, MPH
• Robert a. Rosenfeld DDS (a Professional Dental Corporation)
• Robert S Yuhas MD Inc

• Family Nurse Practitioner in Solana Beach, CA
• Providers in Solana Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.