Healthcare Provider Details

I. General information

NPI: 1952868119
Provider Name (Legal Business Name): MARITZA FRANQUI JARRETT CNM, WHNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6615 LELAND WAY
LOS ANGELES CA
90028-7814
US

IV. Provider business mailing address

6615 LELAND WAY
LOS ANGELES CA
90028-7814
US

V. Phone/Fax

Practice location:
  • Phone: 347-661-8287
  • Fax:
Mailing address:
  • Phone: 347-661-8287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number236388
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95026628
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: