Provider Demographics
NPI:1518182591
Name:KABUNDI, EVELYNE AJEAKWA
Entity Type:Individual
Prefix:MRS
First Name:EVELYNE
Middle Name:AJEAKWA
Last Name:KABUNDI
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 1:26274 JAYLENE ST
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4940
Mailing Address - Country:US
Mailing Address - Phone:909-919-8507
Mailing Address - Fax:
Practice Address - Street 1:26274 JAYLENE ST
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-4940
Practice Address - Country:US
Practice Address - Phone:909-919-8507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN193492164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse