Provider Demographics
NPI:1659123701
Name:GITAU, JOYCE
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:
Last Name:GITAU
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 1:25800 INDUSTRIAL BLVD # P2212
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-2935
Mailing Address - Country:US
Mailing Address - Phone:510-584-6582
Mailing Address - Fax:
Practice Address - Street 1:25800 INDUSTRIAL BLVD # P2212
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-2935
Practice Address - Country:US
Practice Address - Phone:510-584-6582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95177289163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse