Provider Demographics
NPI:1003706813
Name:GACEGU, MONICAH WAITHIRA
Entity type:Individual
Prefix:
First Name:MONICAH
Middle Name:WAITHIRA
Last Name:GACEGU
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 1:2623 NAVAJO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3270
Mailing Address - Country:US
Mailing Address - Phone:707-703-2565
Mailing Address - Fax:
Practice Address - Street 1:2623 NAVAJO ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3270
Practice Address - Country:US
Practice Address - Phone:707-703-2565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-04
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95073183163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse