Healthcare Provider Details

I. General information

NPI: 1053245258
Provider Name (Legal Business Name): JADE NJIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41-550 ECLECTIC PALM DESERT, CA 92260
ECLECTIC PALM DESERT CA
19018
US

IV. Provider business mailing address

17 S DIAMOND ST
CLIFTON HEIGHTS PA
19018-2323
US

V. Phone/Fax

Practice location:
  • Phone: 760-299-5181
  • Fax:
Mailing address:
  • Phone: 215-796-5403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: