Provider Demographics
NPI:1396102844
Name:VENEGAS, NOHEMI
Entity type:Individual
Prefix:
First Name:NOHEMI
Middle Name:
Last Name:VENEGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 HIGH ST STE C
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-2960
Mailing Address - Country:US
Mailing Address - Phone:661-725-2788
Mailing Address - Fax:
Practice Address - Street 1:1700 MCHENRY AVE UNIT 11B1700
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4373
Practice Address - Country:US
Practice Address - Phone:209-273-4723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes372600000XNursing Service Related ProvidersAdult Companion