Provider Demographics
NPI:1386524064
Name:DJIDJOHO, SENA IMMACULEE
Entity type:Individual
Prefix:
First Name:SENA
Middle Name:IMMACULEE
Last Name:DJIDJOHO
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 1:9239 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-1933
Mailing Address - Country:US
Mailing Address - Phone:402-399-8888
Mailing Address - Fax:
Practice Address - Street 1:9239 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-1933
Practice Address - Country:US
Practice Address - Phone:402-399-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE27594364SS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SS0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistSchoolGroup - Single Specialty