Jeth Justine Tancioco

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

684271 Issued in CA

Practice address

36823 Ruschin Dr
Newark, CA 94560-3142

Phone

(510) 701-6393

NPI assigned

Apr 5, 2021

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1720667983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36823 RUSCHIN DR",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945603142",
            "telephone_number": "510-701-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36823 RUSCHIN DR",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945603142",
            "telephone_number": "510-701-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANCIOCO",
        "first_name": "JETH",
        "middle_name": "JUSTINE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "684271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy Tadeo
• Hubert Tai
• Debra L Takigawa
• Rexson Talens
• Elizabeth Yap Tan, D.M.D.
• Bryan C Taylor, RDT
• Verne Taylor
• Denise Teodosio
• Michael Tereo, D.C.
• Teresa Tran Mercado, DDS Dental Corporation

• Licensed Vocational Nurse in Newark, CA
• Providers in Newark, 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 Apr 5, 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.