Healthcare Provider Details

I. General information

NPI: 1003200734
Provider Name (Legal Business Name): JASMIN LILY ESHRAGH C.N.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 03/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 TAYLOR BLVD SUITE 101
PLEASANT HILL CA
94523-2147
US

IV. Provider business mailing address

400 TAYLOR BLVD SUITE 101
PLEASANT HILL CA
94523-2147
US

V. Phone/Fax

Practice location:
  • Phone: 925-825-8878
  • Fax: 925-825-8613
Mailing address:
  • Phone: 925-825-8878
  • Fax: 925-825-8613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SX0200X
TaxonomyOncology Clinical Nurse Specialist
License Number4170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: