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General NPI Number Information
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NPI Number | 1033071519
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Entity Type | Individual
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Provider Name | PATRICIA G NIETO
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1256 BROADWAY AVE # 7
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City | EL CENTRO
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State | CA
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Zip | 92243-2317
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Country | US
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Telephone | 760-352-5712
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Fax | 760-337-3139
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Provider Business Mailing Address
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Address Line | 1197 TURQUOISE ST
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City | CALEXICO
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State | CA
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Zip | 92231-4045
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Country | US
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Telephone | 760-352-5712
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Fax | 760-337-3139
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | VN168150
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License Number State | CA
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