Individual provider Active NPI

Lilian Atieno Juma, RN

  • General Practice Registered Nurse
  • Elk Grove, CA
National Provider Identifier
1386354819
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
95194145 Issued in CA
Practice address
8825 MD Bush Dr
Elk Grove, CA 95758-1338
Phone
(507) 351-2336
NPI assigned
Nov 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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 95194145 CA Primary

Addresses

Primary practice location

8825 MD Bush Dr
Elk Grove, CA 95758-1338

Mailing address

8825 MD Bush Dr
Elk Grove, CA 95758-1338
Phone (507) 351-2336

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
95194145CAMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1386354819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8825 MD BUSH DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957581338",
            "telephone_number": "507-351-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 MD BUSH DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957581338",
            "telephone_number": "507-351-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMA",
        "first_name": "LILIAN",
        "middle_name": "ATIENO",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95194145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.