Individual
JONATHAN ANDREW NEGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
9985 SIERRA AVE # 8, FONTANA, CA 92335-6720
(909) 427-6299
Mailing address
9985 SIERRA AVENUE, MOB #8, FONTANA, CA 92335
(909) 427-6299
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
10975
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0373377-28
ACNP CERTIFICATION
CA
01
—
10975
NP
CA
01
—
10975
PRACTITIONER FURNISHING
—
01
—
523736
RN LICENSE
CA
Enumeration date
10/24/2007
Last updated
10/23/2021
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