Annex A.

List of Provider Assignment of DepEd Personnel

LIST OF PROVIDER AS
Name of Division: Capiz
Name of School:
Ivisan National High School
PhilHealth Identification
Number (PIN)
190898443136
110000069655
110000081892
110000082023
010503040161
110001193945
112013798829
110503229900
110000081922
110000081965
110503688247
110000084336
110503862239
110001131362
110000081868
110000082090
110001412167
110000081876
110000081841
020500281341
110000081973
110000082031
110503368145
110252935886
110001222430
110001363549
112007438896
110000081779
110000082228
110000967580
110000081574
110000081930
110000082058
110000082104
110503923645
110001363530
110000077828
110001161679
110502952676
110000082074
110253474645
20502480880
110001412175
110000082155
110000081949

Last Name
Abarra
Abarra
Abarra
Acta
Afable
Alba
Aman
Andrada
Apruebo
Apruebo
Aragon
Aranda
Yusal
Arbis
Arroyo
Ballera
Baquiral
Baranda
Bellosillo
Bentazal
Boladas
Boluso
Buan
Buenviaje
Caguitquit
Cargando
Cargando
Castro
De Domingo
Del Rosario
Domingo
Doroteo
Ebagat
Eslaban
Fayo
Flagne
Fundal
Gayoba
Guillermo
Lachica
Lausa
Lausa
Lazo
Loberes
Martinez

First Name
Maria Cristina
Minard
Nona
Jocelyn
Cristine
Ana Marie
Maria Fe
Rousell
Ione
Rosario
Argentina
Ronilo
Joan
Elma
Towa
Luthgarda
Maria Dia
Jose Ruel
Gina
Alfredo Jr.
Yolanda
Lutgarda
Joyce
May
Normylie
Ian
Vito
Maria Salvacion
Eva
Mary Ann
Mary Ann
Angeles
Salonga
Ma. Luz
Bernie
Myreen
Leorico
Alvhee Claudette
Linuel
Maria Luz
Harlequin Ruth
Vincent
Jo Faith
Carmelita
Arnel

110504385973
Martinez
Clayde Ann
110000081523
Matayabas
Flordeliza
110001012029
Oabe
Lowela
110000082066
Obligacion
Rosario
110000082171
Odicta
Analie
110000082201
Panaga
Jonathan
110000081736
Pisuea
Susanita
110000084360
Quiachon
Melanie
110000082236
Rapiz
Nestor
110503753332
Recodo
Ma. Fatima
110000082198
Tibor
Joffrey
110000082120
Traje
Naty Marie
110001012010
Tugna
Ma. Elena
110000081663
Uguil
Susan
110000084344
Unarce
Herminio
110252442839
Ureta
Vincent
112008142559
Valbarez
Catherine
110001142585
Valbarez
Janel
110000084352
Varcas
Noel
110251585288
Vasquez
Cleah
110000082015
Villarisco
Rogelito
110000082252
Villasoto
Maria Fe
110253418753
Villasoto
Pauline
20505984359
Waquez
Jay Ann
110253291990
Dorde
Merryday
110506178827
Farinas
Larry Mar
110000082244
Valbarez
Erdelinda
110000082163
Manero
Arnel
*NOTE: For Personnel without PIN, place them on the last part of the list

Signature:

Date

Prepared by:

Signature
Recommending Approval:

FLORDELIZA P. MATAYABAS

LEORICO G. FUNDAL

NURSE II

School Principal III

LIST OF PROVIDER ASSIGNMENT OF DepEd PERSONNEL

Middle Name
Robil
Bautista
Bautista
Fernando
Alicaya
Catubuan
Datiles
Vidal
Velasco
Flores
Bueno
De Tomas
Aranzado
Artuz
Agudo
Deanon
Cambel
Defante
Unarce
Bacarro
Yecla
Azarcon
Besana
Foscablo
Hechanova
Acuyong
Varcas
Andrada
Ortiz
Villasoto
Ariguin
Unarce
Aleligay
Bacamante
Binondo
Geti-ayon
Gaburo
Agapito
Briones
Balivia
Abendan
Dumagpi
Villanueva
Villagracia
Laraya

Birthdate
8/16/1982
3/28/1976
7/29/1955
5/22/1964
12/23/1982
3/7/1983
6/20/1987
9/29/1984
10/31/1960
11/26/1961
4/19/1986
4/21/1960
6/5/1987
10/22/1972
6/8/1955
12/20/1974
9/21/1992
9/9/1971
10/7/1975
9/1/1982
12/11/1965
10/2/1965
10/31/1986
11/6/1987
5/8/1986
12/24/1982
1/8/1956
2/18/1965
2/18/1967
4/7/1979
12/14/1961
10/3/1959
12/25/1965
11/7/1957
1/17/1988
12/19/1991
8/3/1975
4/24/1976
4/17/1983
1/27/1968
6/5/1988
2/12/1983
10/15/1989
11/7/1973
5/9/1957

District
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN

Acepcion
Peroja
Puti
Berja
Dela Cruz
Buni
Malan
Pancho
Abrigana
Portugalite
Bialen
Oas
Jeroso
Feniola
Allaga
Buenviaje
Valcarcel
Denosta
Pamulaya
Ponsaran
Panilagao
Sorallo
Sorallo
Agar
Fegarido
Demaisip
Obienda
Camarista
part of the list

Date

Approval:
LEORICO G. FUNDAL

School Principal III

10/14/1989
10/29/1956
6/15/1979
10/21/1965
2/26/1972
6/10/1972
4/30/1954
2/25/1959
9/8/1960
5/13/1988
5/31/1973
5/21/1958
5/28/1979
12/17/1955
6/16/1953
2/21/1981
4/28/1981
12/23/1982
7/20/1960
12/13/1985
12/26/1951
10/21/1955
7/29/1991
6/17/1982
9/25/1991
4/18/1993
12/5/1952
4/16/1970

IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN

d PERSONNEL

Residential Address
Poblacion Sur, Ivisan, Capiz
Poblacion Sur, Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Cudian, Ivisan, Capiz
Poblacion Sur, Ivisan, Capiz
Lanot, Roxas City
Roxas City
Poblacion Norte, Ivisan, Capiz
Poblacion Sur, Ivisan, Capiz
Poblacion Sur, Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Poblacion Sur, Ivisan, Capiz
Jumaguicjic,Roxas City
Poblacion Norte, Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Poblacion Sur, Ivisan, Capiz
Brgy San Julian, Tapaz, Capiz
Sta. Cruz, Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Cudian, Ivisan, Capiz
Pontevedra, Capiz
Roxas City
Poblacion Norte, Ivisan, Capiz
Balaring, Ivisan, Capiz
Poblcion Norte, Ivisan, Capiz
Matnog, Ivisan, Capiz
Matnog, Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Balijuagan, Roxas City
Sta. Cruz, Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Ondoy, Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Lonoy, Roxas City
Camburana, Tapaz, Capiz
San Nicolas, Tapaz, Capiz
Punta Tabuc, Roxas City
Pob. Norte Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Pob. Norte Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
San Nicolas, Tapaz, Capiz
Poblacion Norte, Ivisan, Capiz
Roxas City

No. of
PhilHealth
Dependents
3
6
0
3
2
3
0
1
2
4
1
0
1
6
1
5
0
1
2
0
0
4
4
0
1
3
3
1
6
3
2
0
3
0
0
1
1
4
0
3
1
3
0
4
1

Preferred PCB 1
Provider
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU
RHU

IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN
IVISAN

Sigma, Capiz
Roxas City
Poblacion Norte, Ivisan, Capiz
Cudian, Ivisan, Capiz
Mianay, Ivisan, Capiz
Mianay, Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Poblacion Norte, Ivisan, Capiz
Poblacion Sur, Ivisan, Capiz
Agustin Navarra, Ivisan, Capiz
brgy Bato, Roxas, City
Pob. Sur Ivisan, Capiz
Pob. Norte Ivisan, Capiz
Pob. Sur Ivisan, Capiz
Pob. Sur Ivisan, Capiz
Agustin Navarra, Ivisan, Capiz
Pob. Sur Ivisan, Capiz
Ilaya, Ivisan Ivisan, Capiz
Pob. Sur Ivisan, Capiz
Pob. Sur Ivisan, Capiz
Pob. Norte Ivisan, Capiz
Pob. Norte Ivisan, Capiz
Pob. Norte Ivisan, Capiz
Malocloc Norte, ivisan, Capiz
Dorado Subd. Roxas City
Brgy Tiza, Roxas, City
Roxas, City
Lambunao, Iloilo

Signature

2
1
2
0
1
2
0
3
0
2
2
1
3
1
1
5
3
3
6
2
1
1
0
2
0
0
1
4

RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
RHU IVISAN
ROXAS CITY HEALTH
ROXAS CITY HEALTH
ROXAS CITY HEALTH
RHU LAMBUNAO

Date

Approved by:
MARLON P. DESTREZA, Ed.D.

Chief Education Supervisor (SGOD)