Individual provider · Type 1 NPI
Watson Kambenja
Gerontology Nurse Practitioner · South Lake Tahoe, CA
NPI number
1720969181
Active
Practice location
PO Box 7899
South Lake Tahoe, CA 96158-0899
Mailing address
3408 Chatham St
Rocklin, CA 95765-1766
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 95036777 (CA) |
Gerontology Nurse Practitioner: Definition to come...
About NPI 1720969181
Watson Kambenja's National Provider Identifier is 1720969181, issued on Sep 10, 2025. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in South Lake Tahoe, CA. The record was last updated on Sep 10, 2025.