Leah Lorraine Fernando Abalon, LVN
Individual provider Active NPI Licensed Practical Nurse · Elk Grove, CA
NPI 1497401129 · NPPES record last updated Sep 18, 2023
Key facts
- NPI
- 1497401129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 720540 (CA)
- Practice address
- 9340 E Stockton Blvd
Elk Grove, CA 95624-1563 - Phone
- (916) 509-8198
- Fax
- (916) 519-8199
- NPI assigned
- Feb 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 720540 | CA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse |
164W00000X | 720540 | CA | Yes |
Addresses
Primary practice location
9340 E Stockton Blvd
Elk Grove, CA 95624-1563
Mailing address
3391 Jola Cir
Sacramento, CA 95832-1548
Phone (510) 253-5203
Other practice location 1
6127 Fair Oaks Blvd
Carmichael, CA 95608-4818
Phone (916) 974-8990
Other names
- NA NA NA
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All providers in Elk Grove, CA · Licensed Practical Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.