Provider Demographics
NPI:1447007398
Name:GAKOBO, WINNIE WANJIRU
Entity type:Individual
Prefix:
First Name:WINNIE
Middle Name:WANJIRU
Last Name:GAKOBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12215 HERITAGE SPRINGS DR APT 103-15
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-6925
Mailing Address - Country:US
Mailing Address - Phone:714-261-3846
Mailing Address - Fax:
Practice Address - Street 1:12215 HERITAGE SPRINGS DR APT 103-15
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-6925
Practice Address - Country:US
Practice Address - Phone:714-261-3846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-30
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95263607163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse