Provider Demographics
NPI:1982224291
Name:EKAI, JACKLINE CHELIMO (RN)
Entity Type:Individual
Prefix:
First Name:JACKLINE
Middle Name:CHELIMO
Last Name:EKAI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6749 RICO CT
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-8993
Mailing Address - Country:US
Mailing Address - Phone:951-427-3380
Mailing Address - Fax:
Practice Address - Street 1:6749 RICO CT
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-8993
Practice Address - Country:US
Practice Address - Phone:951-427-3380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95090306163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse