Active NPI
Jasmine Thao Le
- Family Nurse Practitioner
- Fountain Valley, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95001321
- Practice address
- 17150 Euclid St Ste 200
Fountain Valley, CA 92708-4092 - Phone
- (714) 751-0995
- Fax
- (714) 751-5606
- NPI assigned
- Oct 7, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95001321 | CA | Primary |
Addresses
Primary practice location
17150 Euclid St Ste 200
Fountain Valley, CA 92708-4092
Mailing address
17150 Euclid St Ste 200
Fountain Valley, CA 92708-4092
Phone (714) 751-0995
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Share Our Selves Corporation | Current | Accepting new patients | |
| Healthcare Partners Affiliates Medical Group | Current | Accepting new patients | |
| Healthcare Partners Affiliates Medical Group | Current | Accepting new patients | |
| Share Our Selves Corporation | Current | Accepting new patients |
Locations
1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000
9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3184
824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706
1550 Superior Ave
Costa Mesa, CA 92627
Phone (949) 650-0186
1365 S Grand Ave
Glendora, CA 91740
Phone (626) 385-1456
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
4760 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-0567
393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914
1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526
1014 N Broadway
Santa Ana, CA 92701
Phone (949) 270-1000
888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400
5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Pacific Home Health Care Inc | Home health agency | W-2 Managing Employee | May 1, 2023 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Home Health Agency
- San Gabriel, CA
- NPI 1598781098
W-2 Managing Employee
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Optum
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1659312593
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
dba Share Our Selves Community Health Center
- Federally Qualified Health Center (FQHC)
- Costa Mesa, CA
- NPI 1508073685
-
dba Optum
- Durable Medical Equipment & Medical Supplies
- Murrieta, CA
- NPI 1760057269
-
dba Share Our Selves Pharmacy
- Federally Qualified Health Center (FQHC)
- Costa Mesa, CA
- NPI 1144717778
-
- Federally Qualified Health Center (FQHC)
- Santa Ana, CA
- NPI 1295082774
-
- Health Maintenance Organization
- Los Angeles, CA
- NPI 1134151657
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1710380654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17150 EUCLID ST STE 200",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927084092",
"telephone_number": "714-751-0995",
"fax_number": "714-751-5606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17150 EUCLID ST STE 200",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927084092",
"telephone_number": "714-751-0995",
"fax_number": "714-751-5606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE",
"first_name": "JASMINE",
"middle_name": "THAO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-07",
"last_updated": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95001321",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4760 W Sunset Blvd",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900276063",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.