Provider Demographics
NPI:1942193644
Name:ONDENG, GEORGE JUMA
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:JUMA
Last Name:ONDENG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1963 POWELL ST APT 12
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3659
Mailing Address - Country:US
Mailing Address - Phone:978-483-8728
Mailing Address - Fax:
Practice Address - Street 1:1963 POWELL ST APT 12
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3659
Practice Address - Country:US
Practice Address - Phone:978-483-8728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician