Jazmin Jenae Cunningham

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NP95032520 Issued in CA

Practice address

11401 Heacock St Ste 330
Moreno Valley, CA 92557-7908

Phone

(951) 247-8697

NPI assigned

Jul 30, 2024

Last updated

Nov 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jazmin Jenae Henderson Former name

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhenderson148533@direct.llu.edu

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.

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  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Moreno Valley, CA
  • NPI 1285684605
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Highland, CA
  • NPI 1689624991
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatric Surgery Physician
  • Upland, CA
  • NPI 1861892705
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Orthopaedic Surgery Physician
  • Loma Linda, CA
  • NPI 1275582918
  NPD (past)

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1912736703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501700",
            "telephone_number": "909-558-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 HEACOCK ST STE 330",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577908",
            "telephone_number": "951-247-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "JAZMIN",
        "middle_name": "JENAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP95032520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAZMIN",
            "last_name": "HENDERSON",
            "middle_name": "JENAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rosa M Cuellar Calderon
• Rita Cuellar, IMFT
• Sergio Gabriel Cueva
• Nereida Cuevas-Cardenas
• Levi-Lin Roque Cummings, NP
• William Cunningham, PHARM.D.
• Torie Curiel
• Yuriko Curiel
• Karim Yair Curti Oborsky, MD
• Emily Curtin, DO

• Pediatric Nurse Practitioner in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.