Healthcare Provider Details

I. General information

NPI: 1396102844
Provider Name (Legal Business Name): NOHEMI VENEGAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 MCHENRY AVE UNIT 11B1700
MODESTO CA
95350-4373
US

IV. Provider business mailing address

828 HIGH ST STE C
DELANO CA
93215-2960
US

V. Phone/Fax

Practice location:
  • Phone: 209-273-4723
  • Fax:
Mailing address:
  • Phone: 661-725-2788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: