Healthcare Provider Details

I. General information

NPI: 1144151960
Provider Name (Legal Business Name): JAIME KERNS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14325 GOLDENWEST ST
WESTMINSTER CA
92683-4905
US

IV. Provider business mailing address

14325 GOLDENWEST ST
WESTMINSTER CA
92683-4905
US

V. Phone/Fax

Practice location:
  • Phone: 714-893-1384
  • Fax: 714-894-8226
Mailing address:
  • Phone: 714-893-1384
  • Fax: 714-894-8226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number541646
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: