Jayne Kwon-Clavadetscher, APRN

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

95004414 Issued in CA

Practice address

911 E Plaza Blvd
National City, CA 91950-3523

Phone

(619) 434-0299

NPI assigned

Sep 19, 2014

Last updated

Jul 21, 2022By 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 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• The Women's Health Center of Maui, LLC

  • Specialist
  • Wailuku, HI
  • NPI 1962659714
  NPD (past)

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1922400050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8077 FLORENCE AVE STE 112",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902403894",
            "telephone_number": "562-904-6031",
            "fax_number": "562-905-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 E PLAZA BLVD",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919503523",
            "telephone_number": "619-434-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON-CLAVADETSCHER",
        "first_name": "JAYNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-1790",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "95004414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1922400050",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13998254",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "95004414",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn F. Kreider
• Annette Kruger
• Samuel Kugel, M.D.
• Kuruvadi, D.D.S., Inc.
• Sanjay Kuruvadi, DDS - ORTHODONTIST
• La Maestra Family Clinic (La Maestra Community Health Centers)
• La Maestra Family Clinic (La Maestra Community Health Center)
• La Maestra Family Clinic, Inc.
• La Maestra Family Clinic, Inc. (La Maestra Community Health Centers)
• Thang Quoc La, PHARMD

• Obstetrics & Gynecology Nurse Practitioner in National City, CA
• Providers in National City, CA by specialty
• Obstetrics & Gynecology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.