Provider Demographics
NPI:1447801097
Name:PAMOJA ADVANCED NURSING PRACTICE INC
Entity Type:Organization
Organization Name:PAMOJA ADVANCED NURSING PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:MUMBI
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUNJIRI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:909-702-5650
Mailing Address - Street 1:13215 SUNBIRD DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-5649
Mailing Address - Country:US
Mailing Address - Phone:909-702-5650
Mailing Address - Fax:
Practice Address - Street 1:3400 W BALL RD STE 100B
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3735
Practice Address - Country:US
Practice Address - Phone:144-844-9007
Practice Address - Fax:714-484-4903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty