Provider Demographics
NPI:1912789009
Name:DELIJANI, JASMINE (PMHNP, RN)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:DELIJANI
Suffix:
Gender:F
Credentials:PMHNP, RN
Other - Prefix:MS
Other - First Name:JASMINE
Other - Middle Name:
Other - Last Name:DELIJANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 N CONEJO SCHOOL RD APT 102
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2685
Mailing Address - Country:US
Mailing Address - Phone:818-292-5874
Mailing Address - Fax:
Practice Address - Street 1:17075 DEVONSHIRE ST STE 204
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-5408
Practice Address - Country:US
Practice Address - Phone:661-373-6735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028959363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health