Healthcare Provider Details

I. General information

NPI: 1093323859
Provider Name (Legal Business Name): WINNIE NJAGI KAGENDO DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2020
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W COLLEGE ST STE 188
LOS ANGELES CA
90012-1093
US

IV. Provider business mailing address

29471 TWINBERRY CIR
MENIFEE CA
92584-5214
US

V. Phone/Fax

Practice location:
  • Phone: 909-780-2003
  • Fax:
Mailing address:
  • Phone: 909-780-2003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95031501
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: