Fanta Jalabah

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1126205 Issued in TX

Practice address

2021 Guadalupe St Ste 260
Austin, TX 78705-5654

Phone

(646) 453-6777

NPI assigned

Dec 18, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1972371243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4742 LONESTONE CIR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774491540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 GUADALUPE ST STE 260",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787055654",
            "telephone_number": "646-453-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALABAH",
        "first_name": "FANTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1126205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ruth Jajosky, M.D.
• Elizabeth Jakobsohn
• Jelena Jakovljeivc
• Rima E Jakstys, MD
• Brent Jakubec, M.D.
• Roh-Allah Jalil
• Jana Jamail, CNS
• Fariba Jamali
• James a. Black, M.D.
• James Boysen, M.D., PA

• Psychiatric/Mental Health Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.