Provider Demographics
NPI:1043794852
Name:NDUNGU, JOSEPHINE WANGUI
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:WANGUI
Last Name:NDUNGU
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 1:20550 SUMMERTOWN ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-3628
Mailing Address - Country:US
Mailing Address - Phone:469-685-4627
Mailing Address - Fax:
Practice Address - Street 1:20550 SUMMERTOWN ST
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-3628
Practice Address - Country:US
Practice Address - Phone:469-685-4627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA750200164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse