Provider Demographics
NPI:1306588587
Name:KAGUANJA, FLORENCE (LVN)
Entity type:Individual
Prefix:MRS
First Name:FLORENCE
Middle Name:
Last Name:KAGUANJA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 PLAZA AVILA
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-0134
Mailing Address - Country:US
Mailing Address - Phone:714-612-7844
Mailing Address - Fax:
Practice Address - Street 1:85 PLAZA AVILA
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-0134
Practice Address - Country:US
Practice Address - Phone:714-612-7844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA719237164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse