Provider Demographics
NPI:1467919662
Name:ASARE, JENNIFER (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:ASARE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15507 S NORMANDIE AVE # 492
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-4013
Mailing Address - Country:US
Mailing Address - Phone:310-925-1331
Mailing Address - Fax:
Practice Address - Street 1:22211 NORMANDIE AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-4117
Practice Address - Country:US
Practice Address - Phone:310-925-1331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95058645163WA2000X, 163WE0003X, 163WH0200X, 163WC0200X, 163W00000X
CA95058646208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine