Provider Demographics
NPI:1699501833
Name:KITHUSI, DAMARIS MWONGELI
Entity type:Individual
Prefix:
First Name:DAMARIS
Middle Name:MWONGELI
Last Name:KITHUSI
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 1:3130 PARK BLVD APT E
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-3933
Mailing Address - Country:US
Mailing Address - Phone:510-940-5402
Mailing Address - Fax:
Practice Address - Street 1:3130 PARK BLVD APT E
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-3933
Practice Address - Country:US
Practice Address - Phone:510-940-5402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula