Individual provider Active NPI

Donald Eugene Harjo, CNA, PHLEBOTOMIST

  • Nurse's Aide
  • Bishop, CA
National Provider Identifier
1174940514
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
00885714 Issued in CA
Practice address
511 S PA Ha LN
Bishop, CA 93514-3057
Phone
(760) 920-2553
NPI assigned
Mar 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X 001 UT
Nurse's Aide 376K00000X 00885714 CA Primary

Addresses

Primary practice location

511 S PA Ha LN
Bishop, CA 93514-3057

Mailing address

511 S PA Ha LN
Bishop, CA 93514-3057
Phone (760) 920-2553

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

State licenses

LicenseStateTypeSpecialty
00885714CAMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1174940514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 S PA HA LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935143057",
            "telephone_number": "760-920-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 S PA HA LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935143057",
            "telephone_number": "760-920-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARJO",
        "first_name": "DONALD",
        "middle_name": "EUGENE",
        "credential": "CNA, PHLEBOTOMIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "UT",
            "license": "001",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "CA",
            "license": "00885714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bishop, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.