N/a

Primary specialty

Registered NurseTaxonomy code 163W00000X

Legal business name

N/A

Practice address

29078 Providence Rd
Temecula, CA 92591-5597

Phone

(951) 970-2856

NPI assigned

Nov 30, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Jhermie Bustamante Salas

Title

RN

Phone

(951) 970-2856

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1801163118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29078 PROVIDENCE RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925915597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29078 PROVIDENCE RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925915597",
            "telephone_number": "951-970-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N/A",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "SALAS",
        "authorized_official_first_name": "JHERMIE",
        "authorized_official_middle_name": "BUSTAMANTE",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "951-970-2856",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Temecula, CA
• Providers in Temecula, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.