Provider Demographics
NPI:1467679688
Name:LIGONDE, ADELINE (FNP)
Entity Type:Individual
Prefix:
First Name:ADELINE
Middle Name:
Last Name:LIGONDE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W GRANGEVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-2861
Mailing Address - Country:US
Mailing Address - Phone:559-587-1100
Mailing Address - Fax:559-587-9044
Practice Address - Street 1:515 W GRANGEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-2861
Practice Address - Country:US
Practice Address - Phone:559-587-1100
Practice Address - Fax:559-587-9044
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP15711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFNP15711OtherCA FNP LIC#