Healthcare Provider Details

I. General information

NPI: 1386252518
Provider Name (Legal Business Name): REGINA MURIITHI NJOROGE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13009 QUAIL CT
RANCHO CUCAMONGA CA
91739-8854
US

IV. Provider business mailing address

13009 QUAIL CT
RANCHO CUCAMONGA CA
91739-8854
US

V. Phone/Fax

Practice location:
  • Phone: 951-445-9663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number95194442
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: