Healthcare Provider Details

I. General information

NPI: 1841091352
Provider Name (Legal Business Name): EDWARD NJOROGE NYAGAH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2044 W QUEENS WAY
HANFORD CA
93230-9176
US

IV. Provider business mailing address

2044 W QUEENS WAY
HANFORD CA
93230-9176
US

V. Phone/Fax

Practice location:
  • Phone: 559-644-2330
  • Fax:
Mailing address:
  • Phone: 559-644-2330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number748044
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: