Jonathan Wibisono, NP

Nurse Practitioner · Beaumont, CA

Individual Active NPI

NPI number 1992158653

Practice location

851 E 6TH St
Suite B-4
Beaumont, CA 92223-2340
Phone
(951) 845-2294

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NPI record

NPI
1992158653
Entity type
Individual (Type 1)
Enumeration date
July 18, 2016
Last updated
July 18, 2016
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nurse Practitioner Primary 363L00000X 95004343 CA

About Jonathan Wibisono

Jonathan Wibisono, NP is a healthcare provider registered in the NPI registry with the primary taxonomy Nurse Practitioner (code 363L00000X). The practice location is 851 E 6TH St, Suite B-4, Beaumont, CA 92223-2340. The NPI number 1992158653 was assigned on July 18, 2016 and the record was last updated on July 18, 2016.

Jonathan Wibisono lists a license in the registry: #95004343 (CA) for Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jonathan Wibisono, NP?

The NPI number is 1992158653.

What is the phone number of Jonathan Wibisono?

The phone number listed for the practice location is (951) 845-2294.

Where is Jonathan Wibisono located?

851 E 6TH St, Suite B-4, Beaumont, CA 92223-2340.

What is the taxonomy code for Jonathan Wibisono?

The primary taxonomy code is 363L00000X – Nurse Practitioner.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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