Jacqueline Harris

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95021489 Issued in CA

Practice address

8900 Beverly Blvd FL 3
West Hollywood, CA 90048-2438

Phone

(310) 423-3949

NPI assigned

Feb 1, 2023

Sex

Female

Sole proprietor

Yes

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

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: jharris217880@direct.cshs.org

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1497451413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 BEVERLY BLVD FL 3",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900482438",
            "telephone_number": "310-423-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 BEVERLY BLVD FL 3",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900482438",
            "telephone_number": "310-423-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "08221225",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harounian, Inc.
• Ethan Harow, MD
• Katrina Latisha Harper-Kirksey, M.D
• Christopher Endom Harris, MD
• Emerson Harris
• Julia Harris
• Vicki Annette Harris
• Meithra Harrison
• Zaruhi Harutyunyan
• Ava Christine Harvey

• Family Nurse Practitioner in West Hollywood, CA
• Providers in West Hollywood, 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 Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.