Healthcare Provider Details

I. General information

NPI: 1609863638
Provider Name (Legal Business Name): NILDA AGNES ABELLA ABELLERA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5720 STONERIDGE MALL RD STE 390
PLEASANTON CA
94588-2831
US

IV. Provider business mailing address

5720 STONERIDGE MALL RD STE 390
PLEASANTON CA
94588-2831
US

V. Phone/Fax

Practice location:
  • Phone: 925-690-5525
  • Fax: 925-425-7030
Mailing address:
  • Phone: 925-690-5525
  • Fax: 925-425-7030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA035884
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: