=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902747660
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET NALWEYISO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2026
-----------------------------------------------------
Last Update Date | 04/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18245 MILLBROOK AVE 18245 MILLBROOK AVE
-----------------------------------------------------
City | LATHROP
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-433-1400
-----------------------------------------------------
Fax | 805-433-1400
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18245 MILLBROOK AVE
-----------------------------------------------------
City | LATHROP
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95330-9234
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-433-1400
-----------------------------------------------------
Fax | 805-433-1400
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 172V00000X
-----------------------------------------------------
Taxonomy Name | Community Health Worker
-----------------------------------------------------
License Number | 95345722
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------