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General NPI Number Information
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NPI Number | 1063341022
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Entity Type | Individual
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Provider Name | JAZMINE MOORE DOUGLAS RN
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Gender | Female
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | PO BOX 2012
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City | INGLEWOOD
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State | CA
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Zip | 90305-0012
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Country | US
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Telephone | 310-525-4905
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2012
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City | INGLEWOOD
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State | CA
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Zip | 90305-0012
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Country | US
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Telephone | 310-525-4905
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 95187846
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 95187846
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 95187846
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 163WP1700X
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Taxonomy Name | Perinatal Registered Nurse
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License Number | 95187846
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 95187846
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License Number State | CA
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