Individual provider Active NPI

Jacqueline Ksajikian, FNP

  • Nurse Practitioner
  • Toluca Lake, CA
National Provider Identifier
1669350559
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95032857 Issued in CA
Practice address
10220 Riverside Dr Ste a
Toluca Lake, CA 91602-2502
Phone
(818) 308-7394
NPI assigned
Aug 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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 95032857 CA Primary

Addresses

Primary practice location

10220 Riverside Dr Ste a
Toluca Lake, CA 91602-2502

Mailing address

2050 Rimcrest Dr
Glendale, CA 91207-1046
Phone (310) 739-7111

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
95032857CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1669350559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 RIMCREST DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912071046",
            "telephone_number": "310-739-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10220 RIVERSIDE DR STE A",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022502",
            "telephone_number": "818-308-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KSAJIKIAN",
        "first_name": "JACQUELINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95032857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toluca Lake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.