Provider Demographics
NPI:1093168031
Name:MBAABU, HELLEN
Entity Type:Individual
Prefix:
First Name:HELLEN
Middle Name:
Last Name:MBAABU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1279 LONGBRANCH RD
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92582-4239
Mailing Address - Country:US
Mailing Address - Phone:951-260-9109
Mailing Address - Fax:
Practice Address - Street 1:1279 LONGBRANCH RD
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92582-4239
Practice Address - Country:US
Practice Address - Phone:951-260-9109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA560335163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse