Provider Demographics
NPI:1548741515
Name:GABOT, ARLENE ACTA (AGNP)
Entity type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:ACTA
Last Name:GABOT
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 CUSTOMER CARE WAY
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-5167
Mailing Address - Country:US
Mailing Address - Phone:209-384-6493
Mailing Address - Fax:855-202-9336
Practice Address - Street 1:857 W CHILDS AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6862
Practice Address - Country:US
Practice Address - Phone:209-385-5600
Practice Address - Fax:209-385-5674
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95184263163W00000X
FLARNP9199667363LG0600X
CA95010972363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse