Provider Demographics
NPI:1730984402
Name:MALECOT, ABIGAIL LYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LYNN
Last Name:MALECOT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:LYNN
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3436 BAYSIDE WALK
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-7544
Mailing Address - Country:US
Mailing Address - Phone:325-370-6368
Mailing Address - Fax:
Practice Address - Street 1:24910 LAS BRISAS RD STE 105
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4010
Practice Address - Country:US
Practice Address - Phone:951-231-1385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033997363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily