Provider Demographics
NPI:1598315962
Name:MUIRURI, SERAH WAMBUI (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:SERAH
Middle Name:WAMBUI
Last Name:MUIRURI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CALIMESA
Mailing Address - State:CA
Mailing Address - Zip Code:92320-1166
Mailing Address - Country:US
Mailing Address - Phone:661-444-4934
Mailing Address - Fax:
Practice Address - Street 1:227 TANGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:CALIMESA
Practice Address - State:CA
Practice Address - Zip Code:92320-1166
Practice Address - Country:US
Practice Address - Phone:661-444-4934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-17
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA798114163WC0200X, 163WR0400X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-SurgicalGroup - Multi-Specialty
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care MedicineGroup - Multi-Specialty
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation