Individual
REX AMBATALI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC, FNP-C
Contact information
Practice address
2633 PACIFIC AVE, STOCKTON, CA 95204-4429
(209) 944-5530
Mailing address
4301 X ST, SACRAMENTO, CA 95817-2214
(916) 734-7463
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95001863
CA
363LF0000X
Family Nurse Practitioner
95001863
CA
Other
Enumeration date
02/06/2015
Last updated
05/14/2025
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