Healthcare Provider Details

I. General information

NPI: 1487542239
Provider Name (Legal Business Name): JIANI LI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 WESTWOOD PLZ
LOS ANGELES CA
90095-8353
US

IV. Provider business mailing address

262 N LOS ROBLES AVE APT 320
PASADENA CA
91101-1535
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-5263
  • Fax:
Mailing address:
  • Phone: 310-775-3041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: