Provider Demographics
NPI:1972202653
Name:MAUMALANGA, VEA JOSHUA
Entity Type:Individual
Prefix:
First Name:VEA
Middle Name:JOSHUA
Last Name:MAUMALANGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 S EL CAMINO REAL STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2381
Mailing Address - Country:US
Mailing Address - Phone:650-393-8970
Mailing Address - Fax:
Practice Address - Street 1:2600 S EL CAMINO REAL STE 100
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2381
Practice Address - Country:US
Practice Address - Phone:650-393-8970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker