Provider Demographics
NPI:1437649779
Name:DE LEON, ARTURO NICOLAS (FNP-C)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:NICOLAS
Last Name:DE LEON
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8872 BERGAMO CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-3050
Mailing Address - Country:US
Mailing Address - Phone:209-327-6332
Mailing Address - Fax:
Practice Address - Street 1:1235 W VINE ST STE 22
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-5144
Practice Address - Country:US
Practice Address - Phone:209-334-8520
Practice Address - Fax:209-334-2109
Is Sole Proprietor?:No
Enumeration Date:2018-05-12
Last Update Date:2018-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008771363LF0000X
CANFP95008771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily