Individual provider Active NPI

Jane Waweru

  • Licensed Vocational Nurse
  • San Jacinto, CA
National Provider Identifier
1225513898
Registry record updated Mar 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
262837 Issued in CA
Practice address
2883 Pansy Way
San Jacinto, CA 92582
Phone
(913) 671-9057
NPI assigned
Sep 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 262837 CA Primary

Addresses

Primary practice location

2883 Pansy Way
San Jacinto, CA 92582

Mailing address

2883 Pansy Way
San Jacinto, CA 92582-3742
Phone (951) 388-7575

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
262837CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1538265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647043200000",
    "number": "1225513898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2883 PANSY WAY",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925823742",
            "telephone_number": "951-388-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2883 PANSY WAY",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "92582",
            "telephone_number": "913-671-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAWERU",
        "first_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-30",
        "last_updated": "2022-03-12",
        "certification_date": "2022-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "262837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.

Verify at the official NPI Registry.