Individual provider Active NPI

Nesren Anton Azer Anton, NP

  • Primary Care Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1316504541
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95011844 Issued in CA
Practice address
1224 Scenic Dr Modesto
Modesto, CA 95350-6137
Phone
(209) 442-6077
Fax
(833) 573-2336
NPI assigned
May 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95011844 CA Primary

Addresses

Primary practice location

1224 Scenic Dr Modesto
Modesto, CA 95350-6137

Mailing address

582 E Harding Way
Stockton, CA 95204-6110
Phone (510) 736-9104

Other practice location 1

922 S Tupper Ct
Mountain House, CA 95391-1426
Phone (510) 736-9104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95011844CAMDPrimary Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: nesren.anton.1@17371.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1316504541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 E HARDING WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046110",
            "telephone_number": "510-736-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 SCENIC DR MODESTO",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506137",
            "telephone_number": "209-442-6077",
            "fax_number": "833-573-2336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "922 S Tupper Ct",
            "address_purpose": "LOCATION",
            "city": "Mountain House",
            "state": "CA",
            "postal_code": "953911426",
            "country_code": "US",
            "telephone_number": "510-736-9104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTON",
        "first_name": "NESREN",
        "middle_name": "ANTON AZER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95011844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.