Provider Demographics
NPI:1588951552
Name:NJENGA, RUTH (LVN)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:NJENGA
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 1:699 LANTANA ST
Mailing Address - Street 2:APT 55
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6196
Mailing Address - Country:US
Mailing Address - Phone:805-240-6960
Mailing Address - Fax:805-484-0613
Practice Address - Street 1:699 LANTANA ST
Practice Address - Street 2:APT 55
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6196
Practice Address - Country:US
Practice Address - Phone:805-240-6960
Practice Address - Fax:805-484-0613
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN248705164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse