Provider Demographics
NPI:1699077065
Name:KANIARU, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:KANIARU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 DAPHNE LN
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-4244
Mailing Address - Country:US
Mailing Address - Phone:909-654-0093
Mailing Address - Fax:
Practice Address - Street 1:664 DAPHNE LN
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-4244
Practice Address - Country:US
Practice Address - Phone:909-654-0093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252131164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse