Jon Carlo Banaag

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

724480 Issued in CA

Practice address

10001 County Farm Rd
Riverside, CA 92503-3507

Phone

(909) 421-7120

NPI assigned

Sep 11, 2023

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1609653963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18612 SANTA ANA AVE",
            "city": "BLOOMINGTON",
            "state": "CA",
            "postal_code": "923162639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 COUNTY FARM RD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033507",
            "telephone_number": "909-421-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAAG",
        "first_name": "JON CARLO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "724480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Michael Baloga, MD
• Dana Balogh
• Tanisha Jordan Balogun
• Dalia N Balsamo, M.D.
• Karly Balvastro
• Joey Patricia Banales
• Maryam Banan
• Lisa Banasiak
• Valerie Banda-Rodriguez
• Miranda Banda

• Licensed Vocational Nurse in Riverside, CA
• Providers in Riverside, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.