Provider Demographics
NPI:1225547458
Name:LAITINEN, JAI (FNP-BC)
Entity type:Individual
Prefix:
First Name:JAI
Middle Name:
Last Name:LAITINEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JIE
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20311 STONE PT
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8668
Mailing Address - Country:US
Mailing Address - Phone:951-813-8767
Mailing Address - Fax:
Practice Address - Street 1:20311 STONE PT
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8668
Practice Address - Country:US
Practice Address - Phone:951-813-8767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA836069163WE0003X
TXAP136060363L00000X
CA95007420363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner