Provider Demographics
NPI:1356058788
Name:MBURU, STEPHEN MUIRURI (LVN)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MUIRURI
Last Name:MBURU
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3157 SONATA CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-3838
Mailing Address - Country:US
Mailing Address - Phone:949-375-1628
Mailing Address - Fax:
Practice Address - Street 1:3157 SONATA CIR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-3838
Practice Address - Country:US
Practice Address - Phone:949-375-1628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA226064164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse