Healthcare Provider Details

I. General information

NPI: 1609709427
Provider Name (Legal Business Name): JADORE ADVANCED NURSING WOUND AND SKIN CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11420 PEPPER LN
BEAUMONT CA
92223-7440
US

IV. Provider business mailing address

11420 PEPPER LN
BEAUMONT CA
92223-7440
US

V. Phone/Fax

Practice location:
  • Phone: 310-491-6928
  • Fax:
Mailing address:
  • Phone: 310-491-6928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AUTUMN COBBS
Title or Position: OWNER
Credential: FNP -C
Phone: 310-491-6928