Healthcare Provider Details

I. General information

NPI: 1639961022
Provider Name (Legal Business Name): ANGELINE NCHAKO NJAMFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 N TRACY BLVD STE A
TRACY CA
95376-2426
US

IV. Provider business mailing address

672 QUAIL RUN CIR
TRACY CA
95377-7032
US

V. Phone/Fax

Practice location:
  • Phone: 350-900-4474
  • Fax:
Mailing address:
  • Phone: 350-900-4474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number394700062
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: