Individual provider Active NPI

Daniella K Rutashongerwa

  • Medical-Surgical Registered Nurse
  • San Pablo, CA
National Provider Identifier
1134986938
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
711694 Issued in CA
Practice address
2121 Vale Rd Apt 46
San Pablo, CA 94806-3856
Phone
(510) 650-5172
NPI assigned
Feb 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 711694 CA Primary

Addresses

Primary practice location

2121 Vale Rd Apt 46
San Pablo, CA 94806-3856

Mailing address

2121 Vale Rd Apt 46
San Pablo, CA 94806-3856
Phone (510) 650-5172

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

LicenseStateTypeSpecialty
711694CAMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1134986938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 VALE RD APT 46",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063856",
            "telephone_number": "510-650-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 VALE RD APT 46",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063856",
            "telephone_number": "510-650-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTASHONGERWA",
        "first_name": "DANIELLA",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "711694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.