Johanna Camille De Jesus, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1119112 Issued in TX

Practice address

14940 Cherry Grove CT
Tustin, CA 92780-6115

Phone

(626) 377-0642

NPI assigned

Sep 21, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Albion Medical Partners of California West P CGroup PAC ID 8921419813, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21072/brand/1/csg/1/fhir/r4
• Direct secure messaging: johanna.de.jesus.1@32527.direct.athenahealth.com

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.

• Albion Medical Partners of California West P C

  dba CareMore Health Medical Partners West, PC

  • Internal Medicine Physician
  • Cerritos, CA
  • NPI 1073110607
  Medicare reassignment Care Compare group NPD
• Southern California Kidney Consultants Inc.

  • Nephrology Physician
  • Garden Grove, CA
  • NPI 1205934783
  Medicare reassignment NPD
• Southern California Kidney Care, PC

  • Nephrology Physician
  • Denver, CO
  • NPI 1801532528

  TX

  Medicare reassignment

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1821711169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14940 CHERRY GROVE CT",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806115",
            "telephone_number": "626-377-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14940 CHERRY GROVE CT",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806115",
            "telephone_number": "626-377-0642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12966 Euclid St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928409203",
            "country_code": "US",
            "telephone_number": "720-204-5760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5605 N MacArthur Blvd Fl 10",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750382617",
            "country_code": "US",
            "telephone_number": "833-595-3559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "JOHANNA",
        "middle_name": "CAMILLE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "211096",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013358",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013358",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1119112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Tustin, CA
• Providers in Tustin, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.