Healthcare Provider Details

I. General information

NPI: 1649951278
Provider Name (Legal Business Name): JULIET NAMALWA DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 S SEPULVEDA BLVD STE 1007
LOS ANGELES CA
90045-3828
US

IV. Provider business mailing address

8540 S SEPULVEDA BLVD
LOS ANGELES CA
90045-3807
US

V. Phone/Fax

Practice location:
  • Phone: 310-410-9325
  • Fax:
Mailing address:
  • Phone: 310-410-9325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95026752
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95144259
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: