BOMNARA DEGROOT FNP NPI 1578105789

NPI Information

  • NPI: 1578105789
  • Provider Name: BOMNARA DEGROOT, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1444 FLORIDA AVE STE 202
    MODESTO, CA
    ZIP 95350
  • Phone: (209) 524-1264

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NPI Details

Bomnara Degroot, FNP is a family nurse practitioner in Modesto, CA. Bomnara Degroot, FNP NPI is 1578105789. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1444 FLORIDA AVE STE 202
MODESTO, CA
ZIP 95350-400
Phone: (209) 524-1264

The NPI 1578105789 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 10/9/2019 and was last updated on 9/2/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine95012814CALIFORNIANo
2363LF0000XNurse PractitionerFamily95012814CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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