Individual provider Active NPI

Jennifer Elizabeth Botte-Frasier, NURSE PRACTITIONER

  • Nurse Practitioner
  • Sherman Oaks, CA
National Provider Identifier
1568281178
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2024028605 Issued in CA
Practice address
5651 Sepulveda Blvd Ste 201
Sherman Oaks, CA 91411-2954
Phone
(818) 788-2400
NPI assigned
Oct 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2024028605 CA Primary

Addresses

Primary practice location

5651 Sepulveda Blvd Ste 201
Sherman Oaks, CA 91411-2954

Mailing address

4928 Lazio Way
Oak Park, CA 91377-5570
Phone (310) 869-8192

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2024028605CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1568281178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4928 LAZIO WAY",
            "city": "OAK PARK",
            "state": "CA",
            "postal_code": "913775570",
            "telephone_number": "310-869-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 SEPULVEDA BLVD STE 201",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914112954",
            "telephone_number": "818-788-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTE-FRASIER",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "2024028605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.