JASON ROBERT HANNIBAL (NPI# 1043811201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043811201 |
| Entity Type | Individual |
| Full Name | JASON ROBERT HANNIBAL |
| Practice Address |
2575 Yorba Linda Blvd Fullerton CA 92831-1615 |
| Mailing Address |
2031 N Derek Dr Apt 244 Fullerton CA 92831-1433 |
| Practice Telephone | 7144497400 |
| Mailing Telephone | 6197573493 |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2575 YORBA LINDA BLVD |
| City | FULLERTON |
| State | CA |
| Zip Code | 92831-1615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841208857 | George William Comer | Optometrist | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1699 | 2006-08-04 |
| 1801497771 | Matthew Roughley | Student in an Organized Health Care Education/Training Program | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1615 | 2020-11-05 |
| 1184225377 | Monica Huyentran Nguyen | Student in an Organized Health Care Education/Training Program | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1615 | 2020-11-04 |
| 1588265854 | Jacinda Chan | Student in an Organized Health Care Education/Training Program | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1615 | 2020-11-04 |
| 1932700200 | Yomeri Gonzalez Castuera | Student in an Organized Health Care Education/Training Program | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1615 | 2020-11-04 |
| 1952902058 | Ryan Paul Taylor | Student in an Organized Health Care Education/Training Program | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1699 | 2020-11-04 |
| 1881295368 | Diem Yen | Student in an Organized Health Care Education/Training Program | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1699 | 2020-11-03 |
| 1780285056 | Vy Tran | Student in an Organized Health Care Education/Training Program | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1615 | 2020-11-03 |
| 1205437605 | Katherine Melissa Sandoval | Student in an Organized Health Care Education/Training Program | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1615 | 2020-11-03 |
| 1831790450 | Lora Slaveeva Kamenova | Student in an Organized Health Care Education/Training Program | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1615 | 2020-11-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982169280 | Jennifer Ann Carroll | Counselor | 2246 N. State College Blvd, Fullerton, CA 92831 | 2019-01-31 |
| 1043733736 | Jimmy K Bhatt | Dentist | 1126 E Commonweath Ave, Fullerton, CA 92831 | 2017-07-25 |
| 1447625090 | Kairos Management | Assisted Living Facility | 1621 E. Chapman Ave, Fullerton, CA 92831 | 2015-12-08 |
| 1407251630 | Sam's West, Inc | Technician/Technologist | 601 S Placentia Ave, Fullerton, CA 92831 | 2014-10-30 |
| 1114361813 | Teresa Kyu Thin Khoo | Internal Medicine | 1907 Deerpark Dr Apt 546, Fullerton, CA 92831 | 2013-04-24 |
| 1699020586 | Julia A Bock | Occupational Therapy Assistant | 1240 N Frances Avenue, Fullerton, CA 92831 | 2012-07-17 |
| 1649566225 | The Center for The Treatment of Addiction | Preferred Provider Organization | 104 N. Raymond Ave., A-2, Fullerton, CA 92831 | 2011-06-22 |
| 1366746877 | Leticia Vallejo | Rehabilitation Practitioner | 801 E.chapman Ave, Fullerton, CA 92831 | 2010-12-28 |
| 1083916860 | Angelica Victoria Norman | Counselor | 801 East Chapman Suite 203, Fullerton, CA 92831 | 2010-11-30 |
| 1457683237 | The Paradise | Home Delivered Meals | 659 S Sate College Blvd., Ste. 51, Fullerton, CA 92831 | 2010-02-04 |
| Find all providers in zip 92831 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413495 | Amanda Ly | Student in an Organized Health Care Education/Training Program | 3164 Highlander Rd, Fullerton, CA 92833-5508 | 2020-09-28 |
| 1366054090 | Rebecca Ramos | Student in an Organized Health Care Education/Training Program | 1235 N Harbor Blvd Ste 115, Fullerton, CA 92832-1323 | 2020-08-24 |
| 1891316584 | Deysi Mejia Mercado | Student in an Organized Health Care Education/Training Program | 126 W Whiting Ave Apt 2, Fullerton, CA 92832-1447 | 2020-05-04 |
| 1205466786 | Zachary Geeseok Oh | Student in an Organized Health Care Education/Training Program | 2012 Brooke Ln, Fullerton, CA 92833-1245 | 2020-01-23 |
| 1841770757 | Brenda Flores | Student in an Organized Health Care Education/Training Program | 801 E. Chapman Ave.,#203, Fullerton, CA 92831-3839 | 2018-08-20 |
| 1639673338 | Arvin Raj Wali | Student in an Organized Health Care Education/Training Program | 2050 Pioneer Ave, Fullerton, CA 92831-1230 | 2018-03-19 |
| 1578078960 | Jae Hee Kim | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave Ste 106, Fullerton, CA 92831-3846 | 2017-12-06 |
| 1528584166 | Kristen Goetz | Student in an Organized Health Care Education/Training Program | 309 N Mountain View Pl Apt 9, Fullerton, CA 92831-4168 | 2017-08-16 |
| 1548785058 | Roland Garcia | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave., 203, Fullerton, CA 92831-3839 | 2017-08-04 |
| 1093241911 | Michael Mosier | Student in an Organized Health Care Education/Training Program | 860 Rancho Cir, Fullerton, CA 92835-3335 | 2017-05-11 |
| Find all providers in FULLERTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.