Nicole Renee Davis-Marenco, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95028700 Issued in CA

Practice address

4125 Bangs Ave
Modesto, CA 95356-8713

Phone

(209) 735-5510

NPI assigned

Jan 22, 2024

Last updated

Jan 16, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Nicole Renee Davis Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Leslie a. Storey, M.D., Inc.

  • MOHS-Micrographic Surgery Physician
  • Fresno, CA
  • NPI 1871023432
  Medicare reassignment NPD
• Sharp Rees-Stealy Medical Group, Inc

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1285616177

  Nurse Practitioner

  Medicare reassignment NPD
• Sharp Rees-Stealy Medical Group, Inc

  • Optometrist
  • San Diego, CA
  • NPI 1063172351
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1114788767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 BANGS AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568713",
            "telephone_number": "209-735-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 BANGS AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568713",
            "telephone_number": "209-735-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-MARENCO",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95028700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DAVIS",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anna Davila, PA
• Anna S Davila, LCSW
• Breana M Davila
• Ruben Alfonzo Davila
• Davis Guest Home, Inc.
• Alexander Allen Davis, M.D.
• Allysha Marie Davis
• Brenda Davis, ORT
• Darlene Davis
• David Lewis Davis, M.D.

• Nurse Practitioner in Modesto, CA
• Providers in Modesto, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.