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General NPI Number Information
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NPI Number | 1821487497
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Entity Type | Individual
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Provider Name | PAMELA ENJEMA MOKOKO FAMILY NURSE PRACTIT
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Gender | Female
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Dates
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Enumeration Date | 01/20/2015
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 36056 DARCY PL
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City | MURRIETA
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State | CA
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Zip | 92562-4563
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Country | US
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Telephone | 833-262-2185
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Fax |
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Provider Business Mailing Address
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Address Line | 27315 JEFFERSON AVE STE J
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City | TEMECULA
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State | CA
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Zip | 92590-5609
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Country | US
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Telephone | 332-622-1858
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Fax | 773-538-6058
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN153499
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License Number State | GA
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