Provider Demographics
NPI:1376259481
Name:MUIA, ALICE NJERI
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:NJERI
Last Name:MUIA
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 1:12840 MONTBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-6769
Mailing Address - Country:US
Mailing Address - Phone:916-289-3116
Mailing Address - Fax:
Practice Address - Street 1:12840 MONTBROOK WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6769
Practice Address - Country:US
Practice Address - Phone:916-289-3116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA286885164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse