Healthcare Provider Details

I. General information

NPI: 1417884602
Provider Name (Legal Business Name): FATIMALOURDES MEDICAL AND NURSING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4471 GINA ST
FREMONT CA
94538-2857
US

IV. Provider business mailing address

4471 GINA ST
FREMONT CA
94538-2857
US

V. Phone/Fax

Practice location:
  • Phone: 408-887-0534
  • Fax:
Mailing address:
  • Phone: 408-887-0534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State

VIII. Authorized Official

Name: GLORIA E FOLLOSCO
Title or Position: OWNER
Credential: FNP
Phone: 718-233-9122