Laura Jardine, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95009979 Issued in CA

Practice address

18785 Brookhurst St
Fountain Valley, CA 92708-7300

Phone

(714) 378-0042

Fax

(714) 968-9129

NPI assigned

Oct 3, 2018

Sex

Female

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ljardine750335@hisp.ehr.sutterhealth.org
• Direct secure messaging: laura.jardine.1@19336.direct.athenahealth.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Nellie Gail Urgent Care Medical Corp

  • Urgent Care Clinic/Center
  • Laguna Hills, CA
  • NPI 1073909859
  Medicare reassignment NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760
  NPD (past)
• Nellie Gail Urgent Care

  • Urgent Care Clinic/Center
  • Laguna Hills, CA
  • NPI 1306214184
  NPD (past)

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1902381155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2218",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945855218",
            "telephone_number": "657-241-3600",
            "fax_number": "657-241-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18785 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087300",
            "telephone_number": "714-378-0042",
            "fax_number": "714-968-9129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 Baker St Ste A102",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926264407",
            "country_code": "US",
            "telephone_number": "714-668-2505",
            "fax_number": "714-668-2515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4950 Barranca Pkwy Ste 104",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926048644",
            "country_code": "US",
            "telephone_number": "949-857-1248",
            "fax_number": "949-559-1165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARDINE",
        "first_name": "LAURA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95107505",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009979",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95009979",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie O Chang, L.Ac.
• Ryan William Jamison, D.O.
• Jane Kakkis, MD, Inc.
• Janice Kassawat, O.D. Inc.
• Dani Skeie Janzen, MPT
• Jared Young Chiropractic, Inc
• Paul D Jaruszewski, D.D.S.
• Joanne Ruth Balatbat Jasmin
• Jay S.H. Masserman, M.D., Inc.
• Garrett Michael Jay

• Family Nurse Practitioner in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.