Provider Demographics
NPI:1144943663
Name:PARLINDUNGAN, BONA (LVN)
Entity type:Individual
Prefix:
First Name:BONA
Middle Name:
Last Name:PARLINDUNGAN
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4753 PISMO BEACH DR
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843-4325
Mailing Address - Country:US
Mailing Address - Phone:916-472-8211
Mailing Address - Fax:
Practice Address - Street 1:1900 DRESDEN DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-8803
Practice Address - Country:US
Practice Address - Phone:916-543-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA278267164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA278267OtherBOARD OF VOCATIONAL NURSING & PSYCHIATRIC TECHNICIANS