Cynthia Bearden Jernigan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10867 Issued in CA

Practice address

11301 Wilshire Blvd
Los Angeles, CA 90073-1003

Phone

(310) 478-3711

Fax

(310) 268-4812

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174542104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19413 CRAIGJON AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907462822",
            "telephone_number": "310-537-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "310-478-3711",
            "fax_number": "310-268-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNIGAN",
        "first_name": "CYNTHIA",
        "middle_name": "BEARDEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA10867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Levenson, M.D., Inc.
• Cindy Lizabeth Jerez
• Dakisha Jerez
• Mia Alejandra Jerez
• Terry P Jerge, M.D.
• Kelly Elizabeth Jernigan, PA-C
• Tamekia Nicole Jernigan
• Jerome E. Goldwasser, M.D.
• Jerome Tepperman Psychology Corp
• Sara M Jerome

• Medical Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.