Cassandra Nichole Banuelos, RN

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

95126731 Issued in CA

Practice address

3812 Athol St
Baldwin Park, CA 91706-3812

Phone

(626) 372-2200

NPI assigned

Apr 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1306428008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 ATHOL ST",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063812",
            "telephone_number": "626-372-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 ATHOL ST",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063812",
            "telephone_number": "626-372-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3812 Athol St",
            "address_purpose": "LOCATION",
            "city": "Baldwin Park",
            "state": "CA",
            "postal_code": "917063812",
            "country_code": "US",
            "telephone_number": "626-372-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANUELOS",
        "first_name": "CASSANDRA",
        "middle_name": "NICHOLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "95126731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baldwin Park Unified School District
• Gerardo Baltierra
• Balwin Park Medical Group, Inc.
• Mira Bansil, PA
• Ariana Malagon Banuelos, MD
• Karina Lisset Barahoona Jr.
• Lisa Maria Barajas, L.C.S.W.
• Jesus Barraza, LCSW
• Rose Basurto-Varela, LCSW
• Martine Bauwens, MD

• All providers in Baldwin Park, CA
• Medical-Surgical Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.