MEDICARE: MISS JENNIFER WANJIRU NJERU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	243843	CA

General Provider Information

NPI Number	:	1386975480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JENNIFER WANJIRU NJERU

Provider Business Mailing Address
First Line	:	4423 44TH ST
Second Line	:	# C
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4343
Country	:	US
Telephone Number	:	619-795-1570
Fax Number	:

Provider Business Practice Location Address
First Line	:	4423 44TH ST
Second Line	:	# C
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4343
Country	:	US
Telephone Number	:	619-795-1570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2010
Last Update Date	:	01/29/2010

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