Provider Demographics
NPI:1740729805
Name:WACHIRA, ESTHER WANJA (NP-C)
Entity type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:WANJA
Last Name:WACHIRA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 HAWAII ST
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-4814
Mailing Address - Country:US
Mailing Address - Phone:213-238-2314
Mailing Address - Fax:800-311-0354
Practice Address - Street 1:601 HAWAII ST
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-4814
Practice Address - Country:US
Practice Address - Phone:213-238-2314
Practice Address - Fax:800-311-0354
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2284310363L00000X
CANP95009486363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology