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General NPI Number Information
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NPI Number | 1326844036
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Entity Type | Individual
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Provider Name | JASMINE ELIZABETH SAMSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/22/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 12501 SEAL BEACH BLVD STE 220
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City | SEAL BEACH
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State | CA
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Zip | 90740-2755
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Country | US
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Telephone | 562-430-1666
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Fax |
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Provider Business Mailing Address
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Address Line | 24271 ENSENADA LN
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City | MISSION VIEJO
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State | CA
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Zip | 92691-4434
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Country | US
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Telephone | 949-300-0045
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95033205
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License Number State | CA
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