Provider Demographics
NPI:1760369581
Name:DYER, WANJIKU WAMBAA
Entity type:Individual
Prefix:MRS
First Name:WANJIKU
Middle Name:WAMBAA
Last Name:DYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WANJIKU
Other - Middle Name:WAMBAA
Other - Last Name:MUCHUGIAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1027 WILSHIRE BLVD APT 611
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3118
Mailing Address - Country:US
Mailing Address - Phone:410-344-3631
Mailing Address - Fax:
Practice Address - Street 1:1027 WILSHIRE BLVD APT 611
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3118
Practice Address - Country:US
Practice Address - Phone:410-344-3631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program