Mrs Deranee Pearl G Tabor, - Licensed Practical Nurse in Lodi, CA

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Mrs Deranee Pearl G Tabor, is a Licensed Practical Nurse based in Lodi, California. Mrs Deranee Pearl G Tabor is licensed to practice in California (license number 704752) and her current practice location is 541 S Ham Ln Ste A&b, Lodi, California. She can be reached at her office (for appointments etc.) via phone at (209) 224-8940.

NPI number for Mrs Deranee Pearl G Tabor is 1245100668 and her current mailing address is 541 S Ham Ln Ste A&b, Lodi, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1245100668.

Contact Information

Mrs Deranee Pearl G Tabor,
541 S Ham Ln Ste A&b,
Lodi, CA 95242-3059
(209) 224-8940
Not Available

Map and Direction




Provider's Profile

Full NameMrs Deranee Pearl G Tabor
GenderFemale
SpecialityLicensed Practical Nurse
Location541 S Ham Ln Ste A&b, Lodi, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1245100668
  • Provider Enumeration Date: 11/10/2025
  • Last Update Date: 12/03/2025

Medical Identifiers

Medical identifiers for Mrs Deranee Pearl G Tabor such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1245100668NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
164W00000XLicensed Practical Nurse 704752 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Deranee Pearl G Tabor is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Deranee Pearl G Tabor,
541 S Ham Ln Ste A&b,
Lodi, CA 95242-3059

Ph: (209) 224-8940		Mrs Deranee Pearl G Tabor,
541 S Ham Ln Ste A&b,
Lodi, CA 95242-3059

Ph: (209) 224-8940

Reviews and Comments


Licensed Practical Nurse Nurses in Lodi, CA

Myra Bustamante,
Licensed Practical Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 12755 N Highway 88, Lodi, CA 95240
Phone: 209-340-5800    Fax: 209-340-5804

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.