JESSICA MIRELLA BANUELOS (NPI# 1205189578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205189578 |
| Entity Type | Individual |
| Full Name | JESSICA MIRELLA BANUELOS |
| Practice Address |
21520 Pioneer Blvd Ste 101 Hawaiian Gardens CA 90716-2603 |
| Practice Telephone | 5622465700 |
| Mailing Telephone | 5622465700 |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872328 | Jessica Banuelos | Case Manager/Care Coordinator | 1021 4th St, Taft, CA 93268-2433 | 2020-08-21 |
| Street Address |
21520 PIONEER BLVD STE 101 |
| City | HAWAIIAN GARDENS |
| State | CA |
| Zip Code | 90716-2603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053708081 | Pathway Medical Group | Specialist | 21500 S. Pioneer Blve Suite 210, Hawaiian Gardens, CA 90716 | 2015-04-16 |
| 1790032605 | Nancy Perez | Registered Nurse | 22009 Verne Ave, Hawaiian Gardens, CA 90716 | 2012-08-09 |
| 1194098210 | Ismael B. Nacino Md Inc | Anesthesiology | 21530 Pioneer Bl, Hawaiian Garden, CA 90716 | 2012-02-21 |
| 1326248832 | William Martin Wright | Counselor | 21520 S. Pioneer Blvd., Hawaiian Gardens, CA 90716 | 2007-07-23 |
| 1134341514 | Girish H Rami | Dentist | 12144 E Carson St, # E, Hawaiian Gardens, CA 90716 | 2007-05-03 |
| 1578684080 | Keun Chan Lee | Dentist | 12531 E Carson St, Hawaiian Gardens, CA 90716 | 2007-04-02 |
| 1154451995 | Consuelo Ramirez | Social Worker | 21520 S. Pioneer Bvld., Suite 110, Hawaiian Gardens, CA 90716 | 2007-03-07 |
| 1326102013 | Hyun Chan Lee | Dentist | 12137 E Carson St, Hawaiian Gardens, CA 90716 | 2006-12-20 |
| 1871656488 | Elena G Ezpeleta | Anesthesiology | 21530 South Pioneer Blvd, Hawaiian Gardens, CA 90716 | 2006-12-18 |
| 1144388687 | Jong Chul Han | Dentist | 11846 E Carson St, Hawaiian Gardens, CA 90716 | 2006-12-05 |
| Find all providers in zip 90716 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477834901 | Armida Valencia | Rehabilitation Practitioner | 21520 Pioneer Blvd Ste 10, Hawaiian Gardens, CA 90716-2603 | 2011-08-29 |
| 1891276234 | Yesenia Chavezgonzalez | Rehabilitation Practitioner | 21520 Pioneer Blvd Ste 203, Hawaiian Gardens, CA 90716-2601 | 2018-08-23 |
| 1497184139 | Fabian Barajas Gonzalez | Rehabilitation Practitioner | 21520 Pioneer Blvd Ste 203, Hawaiian Gardens, CA 90716-2601 | 2013-11-04 |
| 1073861282 | Sofia Marie Martinez I | Rehabilitation Practitioner | 21520 Pioneer Blvd, Hawaiian Gardens, CA 90716-2603 | 2012-08-20 |
| 1427343854 | Jasmin Salazar | Rehabilitation Practitioner | 21520 Pioneer Blvd, Suite 110, Hawaiian Gardens, CA 90716-2603 | 2011-06-14 |
| 1467608604 | Betzey Garcia | Rehabilitation Practitioner | 21520 Pioneer Blvd Ste 110, Hawaiian Gardens, CA 90716-2603 | 2008-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092447 | Isaiah Daniel Clark | Rehabilitation Practitioner | 33600 Mapleton Ave # D2018, Murrieta, CA 92563-4434 | 2020-10-31 |
| 1760089122 | Leslie Ann Showalter | Rehabilitation Practitioner | 6720 Tampa Ave, Reseda, CA 91335-5014 | 2020-10-07 |
| 1508477019 | Brenda Cabrera | Rehabilitation Practitioner | 127 W Hillcrest Blvd, Inglewood, CA 90301-2623 | 2020-08-10 |
| 1669082202 | Brenda Vargas | Rehabilitation Practitioner | 16650 Sherman Way # 201, Van Nuys, CA 91406-3782 | 2020-08-07 |
| 1629696042 | Ashlie Renee Javier | Rehabilitation Practitioner | 1266 Calle Estrella, San Dimas, CA 91773-4080 | 2020-07-13 |
| 1861013757 | Terrisa Noel-rivera Luna | Rehabilitation Practitioner | 11303 Wilshire Blvd Bld 116, Los Angeles, CA 90025-5069 | 2020-05-01 |
| 1780212852 | Isaiah Sanchez | Rehabilitation Practitioner | 10535 Zelzah Ave, Granada Hills, CA 91344-5902 | 2020-04-01 |
| 1235766015 | Theresa Matheson | Rehabilitation Practitioner | 15533 Ryon Ave, Bellflower, CA 90706-3624 | 2020-03-24 |
| 1669008991 | Delman Lee Williams | Rehabilitation Practitioner | 456 E Orange Grove Blvd Ste 140, Pasadena, CA 91104-5235 | 2020-03-18 |
| 1356976864 | Millea Jewel Betts | Rehabilitation Practitioner | 801 E Chapman Ave # Sut203, Fullerton, CA 92831-3839 | 2020-03-04 |
| Find all providers with the same taxonomy | ||||
| City | HAWAIIAN GARDENS |
| Zip Code | 90716 |
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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.