Jeth Justine Tancioco, is a
Licensed Vocational Nurse based in Newark, California. Jeth Justine Tancioco is licensed to practice in California (license number 684271) and his current practice location is
36823 Ruschin Dr, Newark, California. He can be reached at his office (for appointments etc.) via phone at
(510) 701-6393.
NPI number for Jeth Justine Tancioco is 1720667983 and his current mailing address is 36823 Ruschin Dr, Newark, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1720667983.
Provider's Profile
| Full Name | Jeth Justine Tancioco |
|---|
| Gender | Male |
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| Speciality | Licensed Vocational Nurse |
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| Location | 36823 Ruschin Dr, Newark, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1720667983
- Provider Enumeration Date: 04/05/2021
- Last Update Date: 04/05/2021
Medical Identifiers
Medical identifiers for Jeth Justine Tancioco such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720667983 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164X00000X | Licensed Vocational Nurse | 684271 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeth Justine Tancioco is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jeth Justine Tancioco,
36823 Ruschin Dr,
Newark, CA 94560-3142
Ph: (510) 701-6393 | Jeth Justine Tancioco,
36823 Ruschin Dr,
Newark, CA 94560-3142
Ph: (510) 701-6393 |
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