Healthcare Provider Details

I. General information

NPI: 1841176732
Provider Name (Legal Business Name): JAIA BUMAGAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 NOOR AVE STE B
SOUTH SAN FRANCISCO CA
94080-5929
US

IV. Provider business mailing address

40 NIBBI CT
SAN FRANCISCO CA
94134-2418
US

V. Phone/Fax

Practice location:
  • Phone: 833-342-1454
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: