Basic Information
| Provider Information | |||||||||
| NPI: | 1447801097 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PAMOJA ADVANCED NURSING PRACTICE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13215 SUNBIRD DR | ||||||||
| Address2: | |||||||||
| City: | MORENO VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925535649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9097025650 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3400 W BALL RD STE 100B | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928043735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1448449007 | ||||||||
| FaxNumber: | 7144844903 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2019 | ||||||||
| LastUpdateDate: | 03/02/2020 | ||||||||
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| AuthorizedOfficialLastName: | NGUNJIRI | ||||||||
| AuthorizedOfficialFirstName: | MUMBI | ||||||||
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| AuthorizedOfficialTitleorPosition: | NP | ||||||||
| AuthorizedOfficialTelephone: | 9097025650 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | NP | ||||||||
| NPICertificationDate: | 03/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SP0808X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health |
No ID Information.