Dasheavia Jolly, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

848098 Issued in CA

Practice address

1440 N Harbor Blvd Ste 916
Fullerton, CA 92835-4127

Phone

(478) 978-3347

Fax

(424) 349-0011

NPI assigned

Jun 6, 2013

Reactivated

Jan 26, 2022

Last updated

Jan 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Elite Infusion Care LLC

  dba Elite Infusion Care

  • Home Infusion Agency
  • Fullerton, CA
  • NPI 1760148456
  NPD Authorized official
• Elera Staffing, LLC

  • Home Infusion Agency
  • Fullerton, CA
  • NPI 1720733322
  Authorized official Same address or phone

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1811335326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12550 CRENSHAW BLVD APT 219",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902503869",
            "telephone_number": "478-978-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N HARBOR BLVD STE 916",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354127",
            "telephone_number": "478-978-3347",
            "fax_number": "424-349-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "DASHEAVIA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "deactivation_date": "2021-11-03",
        "reactivation_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "CA",
            "license": "848-098",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "CA",
            "license": "848-098",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "848098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Marie Johnson
• Tuxbury Tuxbury Johnson
• Willnette Johnson
• Kimson F Johnston, MA, LMFT
• Robert Knight Johnston, D.C.
• Jon R. Sherman MD., Inc
• Jona Licensed Clinical Social Worker PC
• Jonathan Oh Marriage and Family Therapy Inc.
• Michael Min Kyu Jone
• Alexus Jones

• Registered Nurse in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.