Healthcare Provider Details

I. General information

NPI: 1558223495
Provider Name (Legal Business Name): ELIZABETH NAMONDO ESPSE TENGEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 12TH ST SE STE 350
WASHINGTON DC
20003-3727
US

IV. Provider business mailing address

13105 ROSALIES PROGRESS CT
BOWIE MD
20720-6322
US

V. Phone/Fax

Practice location:
  • Phone: 202-607-5099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number200005767
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: