MEDICARE: NICOLE MASCORRO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1508678814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MASCORRO

Provider Business Mailing Address
First Line	:	300 INTERNATIONAL PKWY STE 200
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	313 COLFAX AVE
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95354-3056
Country	:	US
Telephone Number	:	209-646-7059
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2025
Last Update Date	:	06/04/2026

Similar Medicare Providers

1083295034 — JAZMIN REYNOSO
Practice Location Address:

1115 14TH ST
MODESTO, CA
95354-1003

Practice Phone: 209-572-2589
Practice Fax:

1902788599 — JULIA GONSALVES
Practice Location Address:

121 DOWNEY AVE
MODESTO, CA
95354-1208

Practice Phone: 209-341-1824
Practice Fax:

1821652512 — MARCUS PIRO
Practice Location Address:

421 E MORRIS AVE
MODESTO, CA
95354-0437

Practice Phone: 209-303-4030
Practice Fax:

1578564035 — MR. DAVID ARTHUR OLIPHANT ATC
Practice Location Address:

605 S SANTA CRUZ AVE
MODESTO, CA
95354-4254

Practice Phone: 209-341-7152
Practice Fax: 209-341-4731

1326037599 — BRUCE ALAN HINKLEY OD
Practice Location Address:

1019 16TH ST
MODESTO, CA
95354-1105

Practice Phone: 209-526-2737
Practice Fax: 209-338-0074

1962492991 — DR. GEORGE WALKER COOK D.D.S.
Practice Location Address:

1701 WHIPPOORWILL CT
MODESTO, CA
95354-1669

Practice Phone: 209-578-4031
Practice Fax:

Directions to “ NICOLE MASCORRO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.