MEDICARE: ABIGAIL MENDOZA NIPALES LVN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	747108	CA

General Provider Information

NPI Number	:	1962380154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL MENDOZA NIPALES LVN

Provider Business Mailing Address
First Line	:	3113 DOVEHOUSE LN
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95355-8691
Country	:	US
Telephone Number	:	209-598-8432
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E 15TH ST
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95341-6217
Country	:	US
Telephone Number	:	209-381-6879
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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