Provider Demographics
NPI:1932779733
Name:MUNGAI, MARGARET NDIRU
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:NDIRU
Last Name:MUNGAI
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 1:6935 LAGOON CT
Mailing Address - Street 2:
Mailing Address - City:JURUPA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91752-2783
Mailing Address - Country:US
Mailing Address - Phone:214-551-3309
Mailing Address - Fax:
Practice Address - Street 1:6935 LAGOON CT
Practice Address - Street 2:
Practice Address - City:JURUPA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91752-2783
Practice Address - Country:US
Practice Address - Phone:214-551-3309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95246734163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse