Provider Demographics
NPI:1821487497
Name:MOKOKO, PAMELA ENJEMA (FAMILY NURSE PRACTIT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:ENJEMA
Last Name:MOKOKO
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27315 JEFFERSON AVE STE J
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5609
Mailing Address - Country:US
Mailing Address - Phone:332-622-1858
Mailing Address - Fax:773-538-6058
Practice Address - Street 1:36056 DARCY PL
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4563
Practice Address - Country:US
Practice Address - Phone:833-262-2185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN153499363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner