Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jesse Revin Situmeang

Individual provider Licensed Vocational Nurse · NPI 1164166492

Jesse Revin Situmeang is a Licensed Vocational Nurse in 29 Palms, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2022

Practice location Address checks out

71952 Buena Vista Dr
29 Palms, CA 92277-2076
Phone: (720) 666-0999
Fax: (760) 401-8212
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Vocational Nurse (primary) Taxonomy 164X00000X · Licence 243146 (CA)

Record details

NPI number1164166492
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 22, 2022
Last updated in NPPESApril 22, 2022
Certification dateApril 22, 2022