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General NPI Number Information
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NPI Number | 1063989127
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Entity Type | Individual
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Provider Name | ROSEMOND NUNGE NGUIFFO FNP
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Gender | Female
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Dates
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Enumeration Date | 10/26/2018
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 1425 S MAIN ST
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City | WALNUT CREEK
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State | CA
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Zip | 94596-5318
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Country | US
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Telephone | 925-295-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1893 FIORITA WAY
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City | BRENTWOOD
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State | CA
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Zip | 94513-7222
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Country | US
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Telephone | 925-325-9227
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95010125
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License Number State | CA
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