Provider Demographics
NPI:1497464507
Name:DWUMFOUR, ZINATA DIENGE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ZINATA
Middle Name:DIENGE
Last Name:DWUMFOUR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ZINATA
Other - Middle Name:DIENGE
Other - Last Name:SANGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:308 N LA CADENA DR
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-2946
Mailing Address - Country:US
Mailing Address - Phone:909-321-4700
Mailing Address - Fax:
Practice Address - Street 1:308 N LA CADENA DR
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-2946
Practice Address - Country:US
Practice Address - Phone:909-321-4700
Practice Address - Fax:909-824-2887
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023326363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health