Active NPI
Carol Moraa Machogu
- Registered Nurse
- Jurupa Valley, CA
National Provider Identifier
1124774112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 95260111
- Practice address
- 11972 Gadwall Dr
Jurupa Valley, CA 91752-2941 - Phone
- (612) 644-3974
- NPI assigned
- Feb 28, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95260111 | CA | Primary |
Addresses
Primary practice location
11972 Gadwall Dr
Jurupa Valley, CA 91752-2941
Mailing address
11972 Gadwall Dr
Jurupa Valley, CA 91752-2941
Phone (612) 644-3974
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95260111 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646006400000",
"number": "1124774112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11972 GADWALL DR",
"city": "JURUPA VALLEY",
"state": "CA",
"postal_code": "917522941",
"telephone_number": "612-644-3974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11972 GADWALL DR",
"city": "JURUPA VALLEY",
"state": "CA",
"postal_code": "917522941",
"telephone_number": "612-644-3974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACHOGU",
"first_name": "CAROL",
"middle_name": "MORAA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-28",
"last_updated": "2022-02-28",
"certification_date": "2022-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95260111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jurupa Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.