Provider Demographics
NPI:1437368974
Name:DELAFUENTE, MIFFELDA LECHUGA (RN,BSN,OCN)
Entity Type:Individual
Prefix:
First Name:MIFFELDA
Middle Name:LECHUGA
Last Name:DELAFUENTE
Suffix:
Gender:F
Credentials:RN,BSN,OCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 FROST WAY
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8918
Mailing Address - Country:US
Mailing Address - Phone:209-545-3099
Mailing Address - Fax:
Practice Address - Street 1:1441 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4405
Practice Address - Country:US
Practice Address - Phone:209-576-3880
Practice Address - Fax:209-576-3884
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2333997163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2333997OtherRN LICENSE NUMBER