MEDICARE: JADORE ADVANCED NURSING WOUND AND SKIN CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1609709427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JADORE ADVANCED NURSING WOUND AND SKIN CARE

Provider Business Mailing Address
First Line	:	11420 PEPPER LN
Second Line	:
City	:	BEAUMONT
State	:	CA
Zip	:	92223-7440
Country	:	US
Telephone Number	:	310-491-6928
Fax Number	:

Provider Business Practice Location Address
First Line	:	11420 PEPPER LN
Second Line	:
City	:	BEAUMONT
State	:	CA
Zip	:	92223-7440
Country	:	US
Telephone Number	:	310-491-6928
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AUTUMN COBBS
Credential	:	FNP -C
Telephone Number	:	310-491-6928

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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