Provider Demographics
NPI:1285904086
Name:BABB, DEBORAH JANE (NP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:JANE
Last Name:BABB
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4335-A NORTHSTAR WAY
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8624
Mailing Address - Country:US
Mailing Address - Phone:209-342-5125
Mailing Address - Fax:209-342-5128
Practice Address - Street 1:4335 NORTHSTAR WAY BLDG A
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-8624
Practice Address - Country:US
Practice Address - Phone:209-342-5125
Practice Address - Fax:209-342-5128
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14854363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ25236ZMedicare PIN