Individual provider · Type 1 NPI
Jonathan Wibisono, NP
Nurse Practitioner · Beaumont, CA
Practice location
851 E 6th St, Suite B-4
Beaumont, CA 92223-2340
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 95004343 (CA) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1992158653
Jonathan Wibisono, NP's National Provider Identifier is 1992158653, issued on Jul 18, 2016. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Beaumont, CA. The record was last updated on Jul 18, 2016.