Healthcare Provider Details

I. General information

NPI: 1285552935
Provider Name (Legal Business Name): MALLORY JO FLEMING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD
SALINAS CA
93906-3195
US

IV. Provider business mailing address

14405 DEL MONTE FARMS RD
CASTROVILLE CA
95012-9757
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-4111
  • Fax:
Mailing address:
  • Phone: 303-525-2116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95023556
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: