Provider Demographics
NPI:1720272065
Name:YOUMBI, NJOMO VICTOR (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MR
First Name:NJOMO
Middle Name:VICTOR
Last Name:YOUMBI
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 EDMONDS RD
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-3813
Mailing Address - Country:US
Mailing Address - Phone:650-367-1890
Mailing Address - Fax:650-369-6465
Practice Address - Street 1:200 EDMONDS RD
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-3813
Practice Address - Country:US
Practice Address - Phone:650-367-1890
Practice Address - Fax:650-369-6465
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA640935163W00000X
CA21727363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse