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Individual

DONICA ALEXA LONEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
23196 CANYON LAKE DR S, CANYON LAKE, CA 92587-7570
(702) 485-8593
Mailing address
23196 CANYON LAKE DR S, CANYON LAKE, CA 92587-7570
(702) 485-8593

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA63364
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CA660570
CA
01
PA63364
PA LICENSE
CA
Enumeration date
08/21/2023
Last updated
07/15/2024
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