Active NPI
Renee Cardenas
- Pediatric Nurse Practitioner
- Modesto, CA
National Provider Identifier
1710700356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 95032832
- Practice address
- 3109 Coffee Rd Ste a
Modesto, CA 95355-1766 - Phone
- (209) 522-0001
- NPI assigned
- Nov 4, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 95032832 | CA | Primary |
Addresses
Primary practice location
3109 Coffee Rd Ste a
Modesto, CA 95355-1766
Mailing address
15190 N Locust Tree Rd
Lodi, CA 95240-9349
Phone (209) 747-7182
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95032832 | CA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1710700356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15190 N LOCUST TREE RD",
"city": "LODI",
"state": "CA",
"postal_code": "952409349",
"telephone_number": "209-747-7182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3109 COFFEE RD STE A",
"city": "MODESTO",
"state": "CA",
"postal_code": "953551766",
"telephone_number": "209-522-0001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARDENAS",
"first_name": "RENEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-04",
"last_updated": "2024-11-04",
"certification_date": "2024-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "95032832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.