Healthcare Provider Details

I. General information

NPI: 1376342691
Provider Name (Legal Business Name): JASMINE NOHEALANI MORGAN LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 E FRUIT ST
SANTA ANA CA
92701-4296
US

IV. Provider business mailing address

9068 SYCAMORE AVE UNIT 204
MONTCLAIR CA
91763-1547
US

V. Phone/Fax

Practice location:
  • Phone: 714-953-9373
  • Fax:
Mailing address:
  • Phone: 949-872-4061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number748623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: