Provider Demographics
NPI:1427745074
Name:KINYANJUI, JANE WAMBUI (LVN)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:WAMBUI
Last Name:KINYANJUI
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 1:5843 BRENTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-5686
Mailing Address - Country:US
Mailing Address - Phone:909-263-4742
Mailing Address - Fax:
Practice Address - Street 1:5843 BRENTWOOD PL
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-5686
Practice Address - Country:US
Practice Address - Phone:909-263-4742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA177928164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse