Provider Demographics
NPI:1215574389
Name:BOGNOT, JARREN ASUNCION
Entity Type:Individual
Prefix:
First Name:JARREN
Middle Name:ASUNCION
Last Name:BOGNOT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7798 EBRO VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1123
Mailing Address - Country:US
Mailing Address - Phone:702-513-0057
Mailing Address - Fax:
Practice Address - Street 1:7798 EBRO VALLEY CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1123
Practice Address - Country:US
Practice Address - Phone:702-285-3426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant