Jonvanni Bongolan
NPI 1124335807ActiveIndividual· Nurse Practitioner, Family· La Jolla, CA
Nurse Practitioner, Family in La Jolla, California, licensed in CA, with an NPI issued in September 2010. Enrolled in Medicare as practitioner - nurse practitioner and practitioner - nurse practitioner.
Overview
| NPI | 1124335807 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Sep 2, 2010 |
| Last updated in NPPES | Dec 7, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | 19774 | CA |
| Registered Nurse | 163W00000X | 624546 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (AK); Practitioner - Nurse Practitioner (TX) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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