Active NPI
Jeff R Bagamaspad, RN
- Registered Nurse
- Chula Vista, CA
National Provider Identifier
1083203293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 95085433
- Practice address
- 400 E St
Chula Vista, CA 91910-2413 - Phone
- (619) 621-2622
- NPI assigned
- Jan 12, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95085433 | CA | MD | Registered Nurse |
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95085433 | CA | Primary |
Addresses
Primary practice location
400 E St
Chula Vista, CA 91910-2413
Mailing address
1444 Horn Canyon Ave
Chula Vista, CA 91915-1644
Phone (619) 402-3960
NPI Registry JSON
{
"created_epoch": "1610409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610409600000",
"number": "1083203293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1444 HORN CANYON AVE",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919151644",
"telephone_number": "619-402-3960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E ST",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919102413",
"telephone_number": "619-621-2622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGAMASPAD",
"first_name": "JEFF",
"middle_name": "R",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-12",
"last_updated": "2021-01-12",
"certification_date": "2021-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95085433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.