Provider Demographics
NPI:1396628350
Name:BUSUEGO, BELINDA AVISO (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:AVISO
Last Name:BUSUEGO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6793 EARHART AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-4117
Mailing Address - Country:US
Mailing Address - Phone:626-429-9785
Mailing Address - Fax:
Practice Address - Street 1:6793 EARHART AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-4117
Practice Address - Country:US
Practice Address - Phone:626-429-9785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036160363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology