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MARIETTA FORMOSO LIGHT NP-C
NPI 1750368650
Nurse Practitioner - Obstetrics & Gynecology in Clovis, CA

Active since December 30, 2005
782 MEDICAL CENTER DR E STE 212, CLOVIS, CA 93611(559) 451-3676(559) 451-3680 Get Directions Write a Review

NPPES record last updated: October 8, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 8, 2020, Nov 7, 2019, Oct 9, 2019 (3 updates tracked since 2019).

About Marietta Formoso Light Np-c NPPES

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

MARIETTA FORMOSO LIGHT NP-C (NPI 1750368650) is an individual obstetrics & gynecology provider in Clovis, California, licensed in California (6030) and active in the NPI registry since December 2005. She maintains a secondary practice location in Clovis.

NPPES Registry Identity

NPI1750368650
Entity TypeIndividualFemale
Primary Taxonomy363LX0001X
Provider Legal NameMARIETTA FORMOSO LIGHTCredential: NP-C
Location Address782 MEDICAL CENTER DR E STE 212Clovis, CA 93611-6889
Mailing Address2625 E Divisadero StFresno, CA 93721-1431 · (559) 443-2682 · Fax (559) 443-2681
Phone(559) 451-3676
Fax(559) 451-3680
Sole ProprietorNo
Enumeration DateDecember 30, 2005
Last NPPES UpdateOctober 8, 20203 updates tracked since enumeration
NPPES CertifiedOctober 8, 2020
✔ NPI 1750368650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Obstetrics & GynecologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LX0001X
License✔ Licensed in CA · 6030
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 6030 (CA)
Also ListedNurse Practitioner · Women's HealthTaxonomy 363LW0102X · License 6030 (CA)
782 MEDICAL CENTER DR E STE 212, Clovis, CA 93611
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Secondary Practice Location 1

Location 1782 Medical Center Dr E # 212Clovis, CA 93611-6889 · Phone (559) 451-3676 · Fax (559) 451-3680

Other Identifiers 2

Other302503CA · Registered Nurse Lic
Other6030CA · Nurse Practitioner Furn

Other Providers at the Same Location NPPES 3

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

DR. ALEXANDRA HOLLY FREEMAN M.D.
Obstetrics & Gynecology (Gynecologic Oncology)
782 MEDICAL CENTER DR E STE 212
CLOVIS, CA 93611
Fresno County (559) 451-3676
WENDY PRICE RN, NP
Nurse Practitioner
782 MEDICAL CENTER DR E STE 212
CLOVIS, CA 93611
Fresno County (559) 375-4313
IRIANA JAIME SADAGHIANI FNP-C
Nurse Practitioner (Family)
782 MEDICAL CENTER DR E STE 212
CLOVIS, CA 93611
Fresno County (559) 451-3676

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 Marietta Light's NPI number?

The NPI number for Marietta Light is 1750368650. It was assigned to this individual provider in the NPPES registry on December 30, 2005.

Where is Marietta Light located?

Marietta Light practices at 782 Medical Center Dr E Ste 212, Clovis, CA 93611. The listed phone number is (559) 451-3676.

What is Marietta Light's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Obstetrics & Gynecology, with taxonomy code 363LX0001X.

When was this NPI record last updated?

The NPPES record for Marietta Light was last updated on October 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.