Provider Demographics
NPI:1922802404
Name:GICHUKI, EDDAH (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:EDDAH
Middle Name:
Last Name:GICHUKI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4604 BRIARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-4108
Mailing Address - Country:US
Mailing Address - Phone:404-725-0970
Mailing Address - Fax:
Practice Address - Street 1:4604 BRIARWOOD DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-4108
Practice Address - Country:US
Practice Address - Phone:404-725-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95110001163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine