Individual provider Active NPI

Jasmin Chang

  • Adult Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1912309329
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95001087 Issued in CA
Practice address
6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone
(858) 859-1188
NPI assigned
Sep 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95001087 CA Primary

Addresses

Primary practice location

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715

Mailing address

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone (858) 859-1188

Other practice location 1

393 Blossom Hill Rd
Suite #390B
San Jose, CA 95123-1652
Phone (408) 794-1250

Other practice location 2

393 Blossom Hill Rd
Suite #390B
San Jose, CA 95123-1652
Phone (408) 794-1250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1912309329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-859-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-859-1188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "393 Blossom Hill Rd",
            "address_2": "Suite #390B",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951231652",
            "country_code": "US",
            "telephone_number": "408-794-1250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "393 Blossom Hill Rd",
            "address_2": "Suite #390B",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951231652",
            "country_code": "US",
            "telephone_number": "408-794-1250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JASMIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95001087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.