Jayne Ranee Antolin

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95006784 Issued in CA

Practice address

69175 Ramon Rd BLDG a
Cathedral City, CA 92234-3344

Phone

(760) 321-6776

NPI assigned

Dec 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Dap Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Borrego Springs, CA
  • NPI 1134144165
  NPD

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1306351689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36289 CHERRYWOOD DR",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923995730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69175 RAMON RD BLDG A",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922343344",
            "telephone_number": "760-321-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOLIN",
        "first_name": "JAYNE RANEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95053544",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• American Care Connection
• Cara Elizabeth Anderson, FNP-BC
• Mark Steven Anderson
• Andrew Rastegar DDS Inc
• Sarahi Angel, ED.S.
• Edgardo Ramos Antonio Jr., LVN
• Karen Antwiler, M.D.
• Kendra June Apostol
• Aragon Medical Transport Inc.
• Elyza Zelya Araniva-Ruiz

• Family Nurse Practitioner in Cathedral City, CA
• Providers in Cathedral City, 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 Apr 16, 2021; 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.