Individual provider · Type 1 NPI

Deranee Pearl G. Tabor

Licensed Practical Nurse · Lodi, CA

NPI number 1245100668 Active

Practice location

541 S Ham Ln Ste A&b
Lodi, CA 95242-3059

Call (209) 224-8940 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X704752 (CA)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

16 other providers at this address

About NPI 1245100668

Deranee Pearl G. Tabor's National Provider Identifier is 1245100668, issued on Nov 10, 2025. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Lodi, CA. The record was last updated on Dec 3, 2025.