Provider Demographics
NPI:1518645993
Name:KAMAU, ERIC (LVN)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:KAMAU
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16945 RAIL WAY
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-8641
Mailing Address - Country:US
Mailing Address - Phone:925-216-2580
Mailing Address - Fax:209-390-8300
Practice Address - Street 1:16945 RAIL WAY
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:95330-8641
Practice Address - Country:US
Practice Address - Phone:925-216-2580
Practice Address - Fax:209-390-8300
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN232288164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse