Justin Parungao Vallarta

Primary specialty

PharmacistTaxonomy code 183500000X

License

82977 Issued in CA

Practice address

975 Sereno Dr
Vallejo, CA 94589-2441

Phone

(707) 853-9133

NPI assigned

Aug 16, 2020

Last updated

Dec 28, 2021By the provider in NPPES

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

Electronic endpoints 1

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": "1597536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1598376188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 HANLON WAY",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945103672",
            "telephone_number": "707-853-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SERENO DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892441",
            "telephone_number": "707-853-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLARTA",
        "first_name": "JUSTIN",
        "middle_name": "PARUNGAO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-16",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "82977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "975 Sereno Dr",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945892441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dawn Arline Valdez, LPT
• Ryan Michael Valdez
• Shelley Anderson Valdivia, SLP-A
• Arielle Vale
• Kelly Marie Valine, PHARM.D
• Vallejo Acquisition Sub, LLC (North Bay Behavioral Health Hospital)
• Vallejo City Unified School District
• Vallejo Emergency Physicians Medical Group Inc.
• Vallejo Foot & Ankle Clinic
• Vallejo Open MRI Center

• Pharmacist in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.