Fidelia Kwamba Fiadoyor

Individual provider Active NPI Registered Nurse · Lathrop, CA

NPI 1710847355 · NPPES record last updated Nov 17, 2025

Key facts

NPI
1710847355
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
664584 (CA)
Practice address
129 Warren Ave
Lathrop, CA 95330-9715
Phone
(209) 774-6105
NPI assigned
Nov 17, 2025
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

LicenseStateTypeSpecialty
664584CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 664584 CA Yes

Addresses

Primary practice location

129 Warren Ave
Lathrop, CA 95330-9715

Mailing address

129 Warren Ave
Lathrop, CA 95330-9715
Phone (209) 774-6105

Other providers in Lathrop, CA

All providers in Lathrop, CA · Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.