Individual provider · Type 1 NPI
Jonvanni Bongolan
Family Nurse Practitioner · La Jolla, CA
NPI number
1124335807
Active
Practice location
9300 Campus Point Dr
La Jolla, CA 92037-1300
Mailing address
4443 Cherokee Ave
San Diego, CA 92116-3610
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 19774 (CA) |
| Registered Nurse | 163W00000X | 624546 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1124335807
Jonvanni Bongolan's National Provider Identifier is 1124335807, issued on Sep 2, 2010. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in La Jolla, CA. The record was last updated on Dec 7, 2010.