Provider Demographics
NPI:1083300099
Name:MUSEMBI-JOHNSON, NAOMI NTHENYA (RN)
Entity Type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:NTHENYA
Last Name:MUSEMBI-JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35478 STOCKTON ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-6230
Mailing Address - Country:US
Mailing Address - Phone:909-717-7172
Mailing Address - Fax:
Practice Address - Street 1:35478 STOCKTON ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-6230
Practice Address - Country:US
Practice Address - Phone:909-437-2696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95051525163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse