Provider Demographics
NPI:1790547008
Name:NJOROGE, ANGELA BRIANNE (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:BRIANNE
Last Name:NJOROGE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3426 STONE RIVER CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-3143
Mailing Address - Country:US
Mailing Address - Phone:209-844-6874
Mailing Address - Fax:
Practice Address - Street 1:632 W 11TH ST
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3856
Practice Address - Country:US
Practice Address - Phone:209-844-6874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028711363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health