Provider Demographics
NPI:1710621123
Name:KAMAU, LUCY W (RN,BSN)
Entity Type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:W
Last Name:KAMAU
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 NEW WELL CT
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-8974
Mailing Address - Country:US
Mailing Address - Phone:151-038-8120
Mailing Address - Fax:
Practice Address - Street 1:640 NEW WELL CT
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:95330-8974
Practice Address - Country:US
Practice Address - Phone:151-038-8120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95190380163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice