Individual provider Active NPI

Jasmine Vitacco

  • Family Nurse Practitioner
  • Woodland Hills, CA
National Provider Identifier
1114600855
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95024858 Issued in CA
Practice address
6041 Variel Ave Apt 430
Woodland Hills, CA 91367-3858
Phone
(682) 561-7385
NPI assigned
Aug 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95024858 CA Primary

Addresses

Primary practice location

6041 Variel Ave Apt 430
Woodland Hills, CA 91367-3858

Mailing address

6041 Variel Ave Apt 430
Woodland Hills, CA 91367-3858
Phone (682) 561-7385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95024858CAMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1114600855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6041 VARIEL AVE APT 430",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913673858",
            "telephone_number": "682-561-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6041 VARIEL AVE APT 430",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913673858",
            "telephone_number": "682-561-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITACCO",
        "first_name": "JASMINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95024858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.