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

Jonathan Wibisono, NP

Individual provider Nurse Practitioner · NPI 1992158653

Jonathan Wibisono, NP is a Nurse Practitioner in Beaumont, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2016
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

851 E 6th St Ste B-4
Beaumont, CA 92223-2340
Phone: (951) 845-2294
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95004343 (CA)

Record details

NPI number1992158653
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorYes
NPI enumeratedJuly 18, 2016
Last updated in NPPESJuly 18, 2016
Mailing address851 E 6th St, Suite B-4, Beaumont, CA 92223-2340

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