Provider Demographics
NPI:1669903621
Name:KARANJA, ANNIE
Entity type:Individual
Prefix:MS
First Name:ANNIE
Middle Name:
Last Name:KARANJA
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 1:25920 IRIS AVE.
Mailing Address - Street 2:SUITE 13A #147
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92551-1658
Mailing Address - Country:US
Mailing Address - Phone:909-389-8293
Mailing Address - Fax:
Practice Address - Street 1:14908 NORFOLK CIR
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-7064
Practice Address - Country:US
Practice Address - Phone:909-389-8293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA638683163W00000X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Yes163W00000XNursing Service ProvidersRegistered Nurse