Provider Demographics
NPI:1851770721
Name:NYAGGAH, SAFARINI NJAMBI (PA)
Entity Type:Individual
Prefix:MISS
First Name:SAFARINI
Middle Name:NJAMBI
Last Name:NYAGGAH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8439 MANUEL RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-2928
Mailing Address - Country:US
Mailing Address - Phone:951-291-3248
Mailing Address - Fax:
Practice Address - Street 1:8439 MANUEL RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-2928
Practice Address - Country:US
Practice Address - Phone:951-291-3248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52279363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant