Provider Demographics
NPI:1437916442
Name:WACHIURI, CHRISTINE WANGARI (RN, MSN, CNS)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:WANGARI
Last Name:WACHIURI
Suffix:
Gender:F
Credentials:RN, MSN, CNS
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:WANGARI
Other - Last Name:KAGIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1287 LONGPORT WAY
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-0982
Mailing Address - Country:US
Mailing Address - Phone:626-641-5181
Mailing Address - Fax:
Practice Address - Street 1:1287 LONGPORT WAY
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-0982
Practice Address - Country:US
Practice Address - Phone:626-641-5181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA677146163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice