Active NPI
Yasaman Ashley Lajevardi, PA
- Surgical Physician Assistant
- Fresno, CA
National Provider Identifier
1144859158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 60508
- Practice address
- 2823 Fresno St
Fresno, CA 93721-1324 - Phone
- (559) 443-2682
- Fax
- (559) 443-2681
- NPI assigned
- Apr 2, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 60508 | CA | |
| Surgical Physician Assistant | 363AS0400X | 60508 | CA | Primary |
Addresses
Primary practice location
2823 Fresno St
Fresno, CA 93721-1324
Mailing address
2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 96158097A9 | Medicaid | CA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | yasaman.lajevardi@tu.edu | ||
| Direct Messaging Address | yasaman.lajevardi@tu.edu |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60508 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1144859158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 E DIVISADERO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211431",
"telephone_number": "559-443-2682",
"fax_number": "559-443-2681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2823 FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211324",
"telephone_number": "559-443-2682",
"fax_number": "559-443-2681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAJEVARDI",
"first_name": "YASAMAN",
"middle_name": "ASHLEY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-02",
"last_updated": "2023-07-17",
"certification_date": "2023-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "60508",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "60508",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "96158097A9",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "yasaman.lajevardi@tu.edu",
"affiliation": "N",
"address_1": "721 Oscar St",
"city": "Vallejo",
"state": "CA",
"country_code": "US",
"postal_code": "945921180",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "yasaman.lajevardi@tu.edu",
"affiliation": "N",
"address_1": "721 Oscar St",
"city": "Vallejo",
"state": "CA",
"country_code": "US",
"postal_code": "945921180",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.