Individual provider Active NPI

Annastacia Nganga

  • Home Health Aide
  • Port Orchard, WA
National Provider Identifier
1710810312
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
759062 Issued in WA
Practice address
533 Radey St
Port Orchard, WA 98366-3235
Phone
(360) 910-4413
Fax
(360) 443-2418
NPI assigned
Jun 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health AideGroup: 193400000X SINGLE SPECIALTY GROUP 374U00000X 759062 WA Primary

Addresses

Primary practice location

533 Radey St
Port Orchard, WA 98366-3235

Mailing address

533 Radey St
Port Orchard, WA 98366-3235
Phone (360) 910-4413

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
759062WAMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1780531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1710810312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 RADEY ST",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663235",
            "telephone_number": "360-910-4413",
            "fax_number": "360-443-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 RADEY ST",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663235",
            "telephone_number": "360-910-4413",
            "fax_number": "360-443-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGANGA",
        "first_name": "ANNASTACIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-04",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": "WA",
            "license": "759062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.