Healthcare Provider Details

I. General information

NPI: 1306634548
Provider Name (Legal Business Name): NAOMI NJORA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2823 JAYDEN WAY
STOCKTON CA
95212-2869
US

IV. Provider business mailing address

2823 JAYDEN WAY
STOCKTON CA
95212-2869
US

V. Phone/Fax

Practice location:
  • Phone: 415-259-1735
  • Fax:
Mailing address:
  • Phone: 415-259-1735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95313435
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: