Healthcare Provider Details

I. General information

NPI: 1598554545
Provider Name (Legal Business Name): MS. JENNIFER CARINA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 E COLORADO BLVD FL 6
PASADENA CA
91105-1938
US

IV. Provider business mailing address

1519 S FAIRFAX AVE APT 3
LOS ANGELES CA
90019-4914
US

V. Phone/Fax

Practice location:
  • Phone: 310-530-1151
  • Fax:
Mailing address:
  • Phone: 562-229-4780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95034442
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: