Provider Demographics
NPI:1750142972
Name:KAGUCHIA, ELIZABETH WAIRIMU (LVN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WAIRIMU
Last Name:KAGUCHIA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8403 ALADO PL
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-2002
Mailing Address - Country:US
Mailing Address - Phone:192-544-6919
Mailing Address - Fax:
Practice Address - Street 1:8403 ALADO PL
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-2002
Practice Address - Country:US
Practice Address - Phone:192-544-6919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA722330164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse