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NPI Code Detail

MEDICARE: JENY JASON ASIS NP

MEDICARE: JENY JASON ASIS NP
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
1363L00000XNurse Practitioner95021967CA
2163W00000XRegistered Nurse764708CA

General Provider Information

NPI Number : 1871220129
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENY JASON ASIS NP
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number : 702-579-3203
Fax Number :
Provider Business Practice Location Address
First Line : 440 E HUNTINGTON DR STE 200
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3775
Country : US
Telephone Number : 626-254-2293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2022
Last Update Date : 05/07/2026

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