Individual provider Active NPI

Jill Raiza Dela Cruz Jarvina, BSN, RN, MSN, FNP-C

  • Family Nurse Practitioner
  • Torrance, CA
National Provider Identifier
1154784569
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003613 Issued in CA
Practice address
1000 W Carson St
Torrance, CA 90502
Phone
(310) 222-2601
NPI assigned
Apr 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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 95003613 CA Primary

Addresses

Primary practice location

1000 W Carson St
Torrance, CA 90502

Mailing address

1000 W Carson St
Torrance, CA 90502-2004
Phone (424) 306-4320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170210000271 CA Practitioner - Nurse Practitioner 2264715606 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
736348CAMDLicensed Vocational Nurse
95003613CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Dec 31, 2016 Accepting new patients
Legacy Outpatient Therapy Services CurrentSince Feb 15, 2018 Accepting new patients
County of Los Angeles CurrentSince Dec 31, 2016 Accepting new patients
Ascend Physical Therapy and Wellness Services, Apc CurrentSince Jan 3, 2020 Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

1000 W Carson St
#980
Torrance, CA 90502

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1154784569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "424-306-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90502",
            "telephone_number": "310-222-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVINA",
        "first_name": "JILL RAIZA",
        "middle_name": "DELA CRUZ",
        "credential": "BSN, RN, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.