Provider Demographics
NPI:1114659901
Name:NJENGA, FAITH NYABITHI
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:NYABITHI
Last Name:NJENGA
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 1:4982 KOKOMO DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1806
Mailing Address - Country:US
Mailing Address - Phone:209-603-2404
Mailing Address - Fax:
Practice Address - Street 1:4982 KOKOMO DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-1806
Practice Address - Country:US
Practice Address - Phone:209-603-2404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95194431163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
95194431OtherNURSING