Healthcare Provider Details

I. General information

NPI: 1659810406
Provider Name (Legal Business Name): STELLA KEMUTO ONDIEKI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STELLA NYARANGI

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45124 10TH ST W
LANCASTER CA
93534-2310
US

IV. Provider business mailing address

5650 JILLSON ST
COMMERCE CA
90040-1482
US

V. Phone/Fax

Practice location:
  • Phone: 562-867-7999
  • Fax:
Mailing address:
  • Phone: 562-867-7999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRE2468
License Number StateGU
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP0185
License Number StateGU
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95005813
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: