Jamie Delloro Tibon

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95007795 Issued in CA

Practice address

1000 W Carson St
Torrance, CA 90502-2004

Phone

(949) 270-2100

Fax

(949) 650-4458

NPI assigned

Dec 5, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Share Our Selves Corporation

  • Federally Qualified Health Center (FQHC)
  • Costa Mesa, CA
  • NPI 1508073685
  Medicare reassignment

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1194230805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20151 SW BIRCH ST STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601794",
            "telephone_number": "949-270-2100",
            "fax_number": "949-650-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "949-270-2100",
            "fax_number": "949-650-4458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1014 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927013408",
            "country_code": "US",
            "telephone_number": "949-270-2100",
            "fax_number": "949-650-4458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIBON",
        "first_name": "JAMIE",
        "middle_name": "DELLORO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-05",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95007795",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95007795",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Thurman
• Deonza Nicole Thymes, M.D.
• Ti-Med,Inc.
• Tiarachrista Villas
• Genevieve Bancale Tibon-Morales, RN
• Tiffany Elizabeth Ellis
• Tiffany Rogers, M.D., M.P.T, Inc.
• Tiffany Rogers, MD, MPT, Inc.
• Kriska Aimee Tiglao, FNP-BC
• Tim K Cha MD Neurology Medical Corporation

• Family Nurse Practitioner in Torrance, CA
• Providers in Torrance, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.