Jennifer Banico Spurgeon, MPT

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5402 Issued in CA

Practice address

11201 Benton St
Loma Linda, CA 92357-1000

Phone

(909) 825-7084

NPI assigned

Aug 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Panopio Banico Former name

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1992810386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BARTON RD APT 2109",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735346",
            "telephone_number": "909-798-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923571000",
            "telephone_number": "909-825-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPURGEON",
        "first_name": "JENNIFER",
        "middle_name": "BANICO",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "29150",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "5402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BANICO",
            "middle_name": "PANOPIO",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gerald Randall Speyer, MFT
• Ronald Spier, DO
• Justin Charles Spooler, M.D.
• Jeremy Dane Sporrong, D.O.
• Jamie L Spotville
• Shreya Sreeram, MD
• Serena Roxane Srikureja, MD
• Wichit Srikureja, M.D.
• Shrinkhala Srivastava, M.D.
• Brian Ssembajjwe

• Physical Therapy Assistant in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.