Healthcare Provider Details

I. General information

NPI: 1780428151
Provider Name (Legal Business Name): FLORENCE MWANGI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9606 OLD BRIDLE CT
SACRAMENTO CA
95827-3232
US

IV. Provider business mailing address

9606 OLD BRIDLE CT
SACRAMENTO CA
95827-3232
US

V. Phone/Fax

Practice location:
  • Phone: 916-793-5850
  • Fax:
Mailing address:
  • Phone: 916-793-5850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number95354703
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: