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MRS. DERANEE PEARL G TABOR
NPI 1245100668
Licensed Practical Nurse in Lodi, CA

Active since November 10, 2025
541 S HAM LN STE A&B, LODI, CA 95242(209) 224-8940 Get Directions Write a Review

NPPES record last updated: December 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 3, 2025, Nov 10, 2025 (2 updates tracked since 2025).

About Mrs. Deranee Pearl G Tabor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. DERANEE PEARL G TABOR (NPI 1245100668) is an individual licensed practical nurse in Lodi, California, licensed in California (704752) and active in the NPI registry since November 2025.

NPPES Registry Identity

NPI1245100668
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameMRS. DERANEE PEARL G TABOR
Location Address541 S HAM LN STE A&BLodi, CA 95242-3059
Mailing Address541 S Ham Ln Ste A&bLodi, CA 95242-3059 · (209) 224-8940
Phone(209) 224-8940
Sole ProprietorNo
Enumeration DateNovember 10, 2025
Last NPPES UpdateDecember 3, 20252 updates tracked since enumeration
NPPES CertifiedDecember 3, 2025
✔ NPI 1245100668 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in CA · 704752
Definition
A licensed practical nurse 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.
541 S HAM LN STE A&B, Lodi, CA 95242
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Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ESPERANZA GONZALES
Counselor (Addiction (Substance Use Disorder))
541 S HAM LN STE A&B
LODI, CA 95242
San Joaquin County (209) 224-8940
CAROL JACINTO
Counselor (Addiction (Substance Use Disorder))
541 S HAM LN STE A&B
LODI, CA 95242
San Joaquin County (209) 224-8940
MRS. CHELSI NICOLE GAPASIN
Counselor
541 S HAM LN STE A&B
LODI, CA 95242
San Joaquin County (856) 439-6111
CHRISTOPHER PEREZ
Counselor (Addiction (Substance Use Disorder))
541 S HAM LN STE A&B
LODI, CA 95242
San Joaquin County (209) 224-8940
MICHAEL JAMES LATORRACA
Counselor (Addiction (Substance Use Disorder))
541 S HAM LN STE A&B
LODI, CA 95242
San Joaquin County (224) 894-0209
CHRISTINA RENEE TOWNSELL
Licensed Psychiatric Technician
541 S HAM LN STE A&B
LODI, CA 95242
San Joaquin County (209) 553-0798
LAURA ALYSSIA HANSEN RAMEREZ
Counselor (Addiction (Substance Use Disorder))
541 S HAM LN STE A&B
LODI, CA 95242
San Joaquin County (209) 224-8940
NATHANIEL ALAN BEECHLER
Counselor (Addiction (Substance Use Disorder))
541 S HAM LN STE A&B
LODI, CA 95242
San Joaquin County (209) 553-0798

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deranee Pearl Tabor's NPI number?

The NPI number for Deranee Pearl Tabor is 1245100668. It was assigned to this individual provider in the NPPES registry on November 10, 2025.

Where is Deranee Pearl Tabor located?

Deranee Pearl Tabor practices at 541 S Ham Ln Ste A&b, Lodi, CA 95242. The listed phone number is (209) 224-8940.

What is Deranee Pearl Tabor's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Deranee Pearl Tabor was last updated on December 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.