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General NPI Number Information
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NPI Number | 1598385890
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Entity Type | Individual
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Provider Name | JASMINE QUERUBIN NP
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Gender | Female
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Dates
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Enumeration Date | 04/16/2020
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Last Update Date | 04/16/2020
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Provider Practice Location Address
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Address Line | 301 S FAIR OAKS AVE STE 403
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City | PASADENA
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State | CA
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Zip | 91105-2562
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Country | US
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Telephone | 626-200-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 831 SAN NICHOLAS DR
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City | WALNUT
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State | CA
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Zip | 91789-4359
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Country | US
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Telephone |
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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 | 95014405
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License Number State | CA
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