Individual provider Active NPI

Jee Jean Tolentino Dykheng, FNP-C

  • Family Nurse Practitioner
  • Winnetka, CA
National Provider Identifier
1386477115
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
830158 Issued in NV
Practice address
20260 Mobile St
Winnetka, CA 91306-4241
Phone
(818) 216-0761
NPI assigned
Aug 26, 2024
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95032051 CA
Family Nurse Practitioner 363LF0000X 830158 NV Primary

Addresses

Primary practice location

20260 Mobile St
Winnetka, CA 91306-4241

Mailing address

4134 Golden Fleece Ave
Las Vegas, NV 89141-9107
Phone (818) 216-0761

Other practice location 1

4134 Golden Fleece Ave
Las Vegas, NV 89141-9107
Phone (818) 216-0761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241016001452 NV Practitioner - Nurse Practitioner 7810429859 Reassigns benefits to 2 organizations
I20241017000801 CA Practitioner - Nurse Practitioner 7810429859 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dynamic Medical Group LLCGroup PAC ID 1153856158, 5 clinicians
Ares Advance Practice LLCGroup PAC ID 5395159107, 8 clinicians

Practice addresses (Care Compare)

3841 W Charleston Blvd
Suite 202
Las Vegas, NV 89102-1858
Phone (702) 780-6868

5660 W Flamingo Rd
Suite B
Las Vegas, NV 89103-2312
Phone (702) 596-2188

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
830158NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Care Home Health Services Inc. Current Accepting new patients
All Home Mobile Services Inc. CurrentSince Aug 2, 2024 Accepting new patients
Signify Health Medical Associates of California, PC CurrentSince Sep 1, 2025 Accepting new patients
Legacy Marketing Worldwide Inc. CurrentSince Feb 1, 2026 Accepting new patients
Beautiful Mind of Las Vegas LLC CurrentSince Mar 24, 2025 Accepting new patients
Ares Advance Practice LLC CurrentSince Sep 8, 2024 Accepting new patients
Osher Resources Inc CurrentSince Sep 23, 2024 Accepting new patients
Dynamic Medical Group LLC CurrentSince Mar 24, 2025 Accepting new patients

Locations

5015 Eagle Rock Blvd
Ste 200
Los Angeles, CA 90041
Phone (323) 455-4868

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

4795 Holt Blvd
Ste 205
Montclair, CA 91763
Phone (714) 496-5710

6350 Laurel Canyon Blvd
Ste 205
North Hollywood, CA 91606
Phone (818) 325-2090

505 Montgomery St
Fl 10
San Francisco, CA 94111
Phone (503) 427-8095

3841 W Charleston Blvd
Ste 202
Las Vegas, NV 89102
Phone (702) 623-7990

5660 W Flamingo Rd
Ste B
Las Vegas, NV 89103
Phone (702) 233-4555

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: jee.jean.dykheng.1@29107.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Divine Careline Health LLCLas Vegas, NV, CCN 297381 Home health agency W-2 Managing Employee Jul 7, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1386477115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4134 GOLDEN FLEECE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891419107",
            "telephone_number": "818-216-0761",
            "fax_number": "818-216-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20260 MOBILE ST",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913064241",
            "telephone_number": "818-216-0761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4134 Golden Fleece Ave",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891419107",
            "country_code": "US",
            "telephone_number": "818-216-0761",
            "fax_number": "818-216-0761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYKHENG",
        "first_name": "JEE JEAN",
        "middle_name": "TOLENTINO",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032051",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "830158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnetka, CA

Sources for this page

Verify at the official NPI Registry.