Individual provider Active NPI

Peninnah Kirwa, RN

  • General Practice Registered Nurse
  • Eastvale, CA
National Provider Identifier
1225548530
Registry record updated Oct 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
95083358 Issued in CA
Practice address
13728 Hidden Riv
Eastvale, CA 92880-8901
Phone
(323) 434-2959
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2017

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 95083358 CA Primary

Addresses

Primary practice location

13728 Hidden Riv
Eastvale, CA 92880-8901

Mailing address

13728 Hidden Riv
Eastvale, CA 92880-8901
Phone (323) 434-2959

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
95083358CAMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1225548530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13728 HIDDEN RIV",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928808901",
            "telephone_number": "323-434-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13728 HIDDEN RIV",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928808901",
            "telephone_number": "323-434-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRWA",
        "first_name": "PENINNAH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95083358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.