Edward Kireri Kamotho

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

811329 Issued in CA

Practice address

11972 Gadwall Dr
Jurupa Valley, CA 91752-2941

Phone

(714) 232-5384

NPI assigned

Aug 2, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Procare Homes LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1538883392
  NPD Authorized official

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1861916637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11972 GADWALL DR",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "917522941",
            "telephone_number": "714-232-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11972 GADWALL DR",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "917522941",
            "telephone_number": "714-232-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMOTHO",
        "first_name": "EDWARD",
        "middle_name": "KIRERI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "811329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jurupa Unified School District
• Jurupa Unified School District
• Jurupa Valley Dental Group, Inc.
• Jurupa Valley Doulas, LLC
• Jurupa Valley Pharmacy Inc.
• Zipporah Wanjeri Kamotho, LVN
• Razieh Karimlangi
• Shawn Keepers
• Kevin E. Lee MFT
• Justin Dongeon Kim, DMD

• Registered Nurse in Jurupa Valley, CA
• Providers in Jurupa Valley, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.