Organization Active NPI

Pamoja Advanced Nursing Practice Inc

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Anaheim, CA
National Provider Identifier
1447801097
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
Legal business name
PAMOJA ADVANCED NURSING PRACTICE INC
Practice address
3400 W Ball Rd Ste 100B
Anaheim, CA 92804-3735
Phone
(144) 844-9007
Fax
(714) 484-4903
NPI assigned
Sep 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Authorized official

Name
Mumbi Ngunjiri, NP
Title
NP
Phone
(909) 702-5650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0808X Primary

Addresses

Primary practice location

3400 W Ball Rd Ste 100B
Anaheim, CA 92804-3735

Mailing address

13215 Sunbird Dr
Moreno Valley, CA 92553-5649
Phone (909) 702-5650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201112002642 CA Part B Supplier - Clinic/Group Practice 5294145694 Receives reassigned benefits from 3 practitioners
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

710 N Euclid St
Ste 208
Anaheim, CA 92801
Phone (714) 484-4900

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1447801097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13215 SUNBIRD DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535649",
            "telephone_number": "909-702-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W BALL RD STE 100B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043735",
            "telephone_number": "144-844-9007",
            "fax_number": "714-484-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAMOJA ADVANCED NURSING PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-25",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "NGUNJIRI",
        "authorized_official_first_name": "MUMBI",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "909-702-5650",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.