Individual provider Active NPI

Jasmine Palmiano Henderson

  • Medical Physician Assistant
  • San Diego, CA
National Provider Identifier
1255717211
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
54230 Issued in CA
Practice address
6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone
(858) 859-1188
NPI assigned
Jul 31, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 54230 CA Primary
Medical Physician Assistant 363AM0700X LA

Addresses

Primary practice location

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715

Mailing address

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone (858) 859-1188

Other practice location 1

2312 E Main St
Suite B
New Iberia, LA 70560
Phone (337) 364-0938

Other practice location 2

5717 Pacific Center Blvd Ste 200
San Diego, CA 92121-4250
Phone (858) 859-1188

Other names 1

  • Jasmine Palmiano Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iberia Familymd, LLC PastSince Oct 10, 2007 Accepting new patients

Organizations & group practices 1

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": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1255717211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-859-1188",
            "fax_number": "844-404-8924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-859-1188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2312 E Main St",
            "address_2": "SUITE B",
            "address_purpose": "LOCATION",
            "city": "New Iberia",
            "state": "LA",
            "postal_code": "70560",
            "country_code": "US",
            "telephone_number": "337-364-0938",
            "fax_number": "337-359-9093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5717 Pacific Center Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921214250",
            "country_code": "US",
            "telephone_number": "858-859-1188",
            "fax_number": "844-404-8924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JASMINE",
        "middle_name": "PALMIANO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "54230",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASMINE",
            "last_name": "PALMIANO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.