Provider Demographics
NPI:1114492790
Name:NDUNGU, JEMIMAH NJERI (RN)
Entity type:Individual
Prefix:
First Name:JEMIMAH
Middle Name:NJERI
Last Name:NDUNGU
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 W CAMERON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2714
Mailing Address - Country:US
Mailing Address - Phone:214-809-5741
Mailing Address - Fax:
Practice Address - Street 1:1626 W CAMERON AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2714
Practice Address - Country:US
Practice Address - Phone:214-809-5741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX947515163W00000X
CA95375296163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse