Jillian Rose Moffett

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95031258 Issued in CA

Practice address

9300 Valley Childrens PL
Madera, CA 93636-8762

Phone

(559) 353-3000

NPI assigned

Sep 13, 2023

Last updated

Oct 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other names 1

• Jillian Rose Balkenhol Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jmoffett92706@valleychildrens-prd.direct-ci.com

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1649057688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 VETERANS BLVD UNIT 516",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368762",
            "telephone_number": "559-353-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFETT",
        "first_name": "JILLIAN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95031258",
            "primary": true
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "CA",
            "license": "95031258",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "153014",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95328625",
            "primary": false
        },
        {
            "code": "163WP0218X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatric Oncology",
            "state": "CA",
            "license": "95328625",
            "primary": false
        },
        {
            "code": "163WP0218X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatric Oncology",
            "state": "CT",
            "license": "153014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "BALKENHOL",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daaman Mittal, MD
• Kathryn Wynn Mittie, MSN, FNP
• Ashley Miyasaki
• Kaydi Mizuguchi, PHARM.D.
• Amy Moffet, DPT
• Mohammad Afzal Arain MD Inc
• Mohammad Ashraf, M.D., Inc.
• Arfan Mohammed, PHARM. D.
• Princess Mohammed, PHARMD
• Shwan Raouf Mohammed, DDS

• Pediatric Nurse Practitioner in Madera, CA
• Providers in Madera, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.