Provider Demographics
NPI:1356823975
Name:NJOROGE, SARAH W
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:W
Last Name:NJOROGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4066 CRAVEN RD UNIT 58
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-7388
Mailing Address - Country:US
Mailing Address - Phone:818-518-7940
Mailing Address - Fax:
Practice Address - Street 1:4066 CRAVEN RD UNIT 58
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-7388
Practice Address - Country:US
Practice Address - Phone:818-518-7940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN240441164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse