Jerome Untalan Ancheta

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

709310 Issued in CA

Practice address

26001 Redlands Blvd
Redlands, CA 92373-7762

Phone

(909) 825-7084

NPI assigned

Aug 19, 2026

Sex

Male

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

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1396651402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5231 EUREKA AVE",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922201324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26001 REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737762",
            "telephone_number": "909-825-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCHETA",
        "first_name": "JEROME",
        "middle_name": "UNTALAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "709310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Redlands, CA
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.