Individual provider Active NPI

Jonathan Shearer

  • Student in an Organized Health Care Education/Training Program
  • San Bernardino, CA
National Provider Identifier
1104759919
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1003 E Brier Dr
San Bernardino, CA 92408-2817
Phone
(909) 382-7100
NPI assigned
Jun 3, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1003 E Brier Dr
San Bernardino, CA 92408-2817

Mailing address

PO Box 208
Forest Falls, CA 92339-0208
Phone (951) 202-6734

Other names 1

  • Jon Shearer Other name

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1104759919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208",
            "city": "FOREST FALLS",
            "state": "CA",
            "postal_code": "923390208",
            "telephone_number": "951-202-6734",
            "fax_number": "951-202-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E BRIER DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082817",
            "telephone_number": "909-382-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JON",
            "last_name": "SHEARER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.