Provider Demographics
NPI:1386975480
Name:NJERU, JENNIFER WANJIRU
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:WANJIRU
Last Name:NJERU
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 1:4423 44TH ST
Mailing Address - Street 2:# C
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-4343
Mailing Address - Country:US
Mailing Address - Phone:619-795-1570
Mailing Address - Fax:
Practice Address - Street 1:4423 44TH ST
Practice Address - Street 2:# C
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-4343
Practice Address - Country:US
Practice Address - Phone:619-795-1570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA243843164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse