Provider Demographics
NPI:1326844036
Name:SAMSON, JASMINE ELIZABETH (FNP-C)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:ELIZABETH
Last Name:SAMSON
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:ELIZABETH
Other - Last Name:DOUGHERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24271 ENSENADA LN
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-4434
Mailing Address - Country:US
Mailing Address - Phone:949-300-0045
Mailing Address - Fax:
Practice Address - Street 1:24271 ENSENADA LN
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-4434
Practice Address - Country:US
Practice Address - Phone:949-300-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033205363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily