Jardine Posadas Marvan, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19221 Issued in CA

Practice address

2011 Wilshire Blvd Ste 300
Los Angeles, CA 90057-3503

Phone

(213) 413-2700

NPI assigned

Oct 21, 2009

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

Other identifiers 1

Other names 1

• Jardine Posadas Dizon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bobby Pezeshki MD Inc

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1164999215
  NPD

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1295061554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 GREENSWARD RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900392110",
            "telephone_number": "323-363-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 WILSHIRE BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573503",
            "telephone_number": "213-413-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVAN",
        "first_name": "JARDINE",
        "middle_name": "POSADAS",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD",
            "identifier": "19221",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JARDINE",
            "last_name": "DIZON",
            "middle_name": "POSADAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lori Rene Marum, ACNP
• Michelle Marumoto
• Gregory Marusak, MD
• Susan Lynn Marusak, MD
• Stephanie Maruska, M.A.
• Daphne Marvel
• Marvi Home Health Inc
• Jennifer Marvil, M.D.
• Marvin B. Carnow D.D.S., Inc.
• Marvin C Lee Chiropractic PC

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.