Individual provider Active NPI

Anasuyaben Dahyalal Jani, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Artesia, CA
National Provider Identifier
1710353065
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95003730 Issued in CA
Practice address
18422 Arline Ave Apt 3
Artesia, CA 90701
Phone
(337) 400-6545
NPI assigned
Aug 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 793448 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95003730 CA Primary

Addresses

Primary practice location

18422 Arline Ave Apt 3
Artesia, CA 90701

Mailing address

18422 Arline Ave
Apt#3
Artesia, CA 90701-5788
Phone (562) 809-1408

Other practice location 1

4411 E Kings Canyon Rd Apt 3
Fresno, CA 93702-3604
Phone (559) 453-1008

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170217001325 CA Practitioner - Nurse Practitioner 0648553636 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
793448CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Exodus Recovery, Inc. CurrentSince Jan 11, 2017 Accepting new patients
Exodus Recovery, Inc. CurrentSince Jan 11, 2017 Accepting new patients
Exodus Recovery Inc Current Accepting new patients

Locations

9808 Venice Blvd
Ste 700
Culver City, CA 90232
Phone (310) 253-9494

12021 Wilmington Ave
Fl 2
Los Angeles, CA 90059
Phone (424) 454-5000

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1710353065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18422 ARLINE AVE",
            "address_2": "APT#3",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907015788",
            "telephone_number": "562-809-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18422 ARLINE AVE APT 3",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "90701",
            "telephone_number": "337-400-6545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4411 E Kings Canyon Rd Apt 3",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937023604",
            "country_code": "US",
            "telephone_number": "559-453-1008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANI",
        "first_name": "ANASUYABEN",
        "middle_name": "DAHYALAL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "793448",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95003730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Artesia, CA

Sources for this page

Verify at the official NPI Registry.