MARIETTA FORMOSO LIGHT NP-C NPI 1750368650

NPI Information

  • NPI: 1750368650
  • Provider Name: MARIETTA FORMOSO LIGHT, NP-C
  • Classification: Nurse Practitioner - 363LX0001X
  • Specialization: Obstetrics & Gynecology
  • Entity Type: Individual
  • Address: 782 MEDICAL CENTER DR E STE 212
    CLOVIS, CA
    ZIP 93611
  • Phone: (559) 451-3676

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NPI Details

Marietta Formoso Light, NP-C is an obstetrics and gynecology nurse practitioner in Clovis, CA. Marietta Formoso Light, NP-C NPI is 1750368650. 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:

782 MEDICAL CENTER DR E STE 212
CLOVIS, CA
ZIP 93611-889
Phone: (559) 451-3676
Fax: (559) 451-3680

The enumeration date for this NPI number is 12/30/2005 and was last updated on 10/8/2020.

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
1363LF0000XNurse PractitionerFamily6030CALIFORNIANo
2363LW0102XNurse PractitionerWomen's Health6030CALIFORNIANo
3363LX0001XNurse PractitionerObstetrics & Gynecology6030CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1302503OTHERCALIFORNIAREGISTERED NURSE LIC
26030OTHERCALIFORNIANURSE PRACTITIONER FURN

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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