Provider Demographics
NPI:1801565544
Name:NJUGUNA, TITUS WAITITU (CERTIFIED CAREGIVER,)
Entity type:Individual
Prefix:
First Name:TITUS
Middle Name:WAITITU
Last Name:NJUGUNA
Suffix:
Gender:M
Credentials:CERTIFIED CAREGIVER,
Other - Prefix:
Other - First Name:TITUS
Other - Middle Name:WAITITU
Other - Last Name:NJUGUNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MANAGER GROUPHOMES
Mailing Address - Street 1:2010 W BRANHAM LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-7718
Mailing Address - Country:US
Mailing Address - Phone:469-254-3912
Mailing Address - Fax:
Practice Address - Street 1:2010 W BRANHAM LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-7718
Practice Address - Country:US
Practice Address - Phone:469-254-3912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ127883747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider