Healthcare Provider Details

I. General information

NPI: 1063880235
Provider Name (Legal Business Name): JELENA SONI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2015
Last Update Date: 06/27/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 W SUNSET BLVD
LOS ANGELES CA
90027-6082
US

IV. Provider business mailing address

76 N SIERRA BONITA AVE APT 9
PASADENA CA
91106-2141
US

V. Phone/Fax

Practice location:
  • Phone: 833-574-2273
  • Fax:
Mailing address:
  • Phone: 626-403-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95020941
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP8038
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: