Healthcare Provider Details

I. General information

NPI: 1659920197
Provider Name (Legal Business Name): LOICE WAMBUI KARANJA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2019
Last Update Date: 09/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S PEPPERTREE ST
VISALIA CA
93277-5505
US

IV. Provider business mailing address

2500 S PEPPERTREE ST
VISALIA CA
93277-5505
US

V. Phone/Fax

Practice location:
  • Phone: 559-805-1213
  • Fax:
Mailing address:
  • Phone: 559-805-1213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number95031664
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: