Alexis Destiny Pellecer, MD
Student in an Organized Health Care Education/Training Program in Ventura, CA. Individual provider (NPI-1).
Details
- NPI
- 1164217428
- Entity type
- Individual (NPI-1)
- Name
- Alexis Destiny Pellecer
- Credential
- MD
- Sole proprietor
- No
- Enumeration date
- Apr 9, 2025
- Certification date
- Apr 8, 2025
- Last updated
- Apr 9, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
300 Hillmont Ave Ste 120Ventura, CA 93003-1651
Phone 805-652-6228
Mailing address
300 Hillmont Ave Ste 120Ventura, CA 93003-1651
Phone 805-652-6228
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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