Individual provider Active NPI

Mary Wairimu Ndungu, RN

  • General Practice Registered Nurse
  • Pasadena, CA
National Provider Identifier
1033780788
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN758929 Issued in CA
Practice address
997 E California Blvd
Pasadena, CA 91106-4046
Phone
(626) 689-3362
NPI assigned
Jul 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN758929 CA Primary

Addresses

Primary practice location

997 E California Blvd
Pasadena, CA 91106-4046

Mailing address

997 E California Blvd
Pasadena, CA 91106-4046
Phone (626) 689-3362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN758929CAMDGeneral Practice Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1033780788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 E CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911064046",
            "telephone_number": "626-689-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 E CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911064046",
            "telephone_number": "626-689-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUNGU",
        "first_name": "MARY",
        "middle_name": "WAIRIMU",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-04",
        "last_updated": "2025-09-11",
        "certification_date": "2025-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "RN758929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.