Provider Demographics
NPI:1669334629
Name:MAVUNA, VIMBAI HELLEN
Entity type:Individual
Prefix:
First Name:VIMBAI
Middle Name:HELLEN
Last Name:MAVUNA
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 1:311 TIDEWAY DR APT 116
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3535
Mailing Address - Country:US
Mailing Address - Phone:415-813-9593
Mailing Address - Fax:
Practice Address - Street 1:311 TIDEWAY DR APT 116
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-3535
Practice Address - Country:US
Practice Address - Phone:415-813-9593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-28
Last Update Date:2025-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty