Healthcare Provider Details

I. General information

NPI: 1427972157
Provider Name (Legal Business Name): ANA GABRIEL LUPIAN REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5178 LUCILLE AVE
ATWATER CA
95301-8870
US

IV. Provider business mailing address

5178 LUCILLE AVE
ATWATER CA
95301-8870
US

V. Phone/Fax

Practice location:
  • Phone: 209-600-1586
  • Fax:
Mailing address:
  • Phone: 209-600-1586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95318366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: