MEDICARE: AIMY JAKINI DNP, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95032868	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	95032868	OTHER	CA	STATE LICENSE
2	95095175	OTHER	CA	REGISTERED NURSE

General Provider Information

NPI Number	:	1699598052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMY JAKINI DNP, PMHNP-BC

Provider Business Mailing Address
First Line	:	2167 BOWDOIN ST
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92878-5474
Country	:	US
Telephone Number	:	949-406-9411
Fax Number	:	949-844-8414

Provider Business Practice Location Address
First Line	:	2167 BOWDOIN ST
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92878-5474
Country	:	US
Telephone Number	:	949-406-9411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	05/22/2026

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