Healthcare Provider Details

I. General information

NPI: 1730822032
Provider Name (Legal Business Name): JASMINE ARIANA FERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 E LIME AVE STE 101102
MONROVIA CA
91016-2982
US

IV. Provider business mailing address

1200 N STATE ST CLINIC TOWER, SUITE A7D
LOS ANGELES CA
90033-1029
US

V. Phone/Fax

Practice location:
  • Phone: 888-499-9303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA189873
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: