Provider Demographics
NPI:1003200734
Name:ESHRAGH, JASMIN LILY (CNS)
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:LILY
Last Name:ESHRAGH
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TAYLOR BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2147
Mailing Address - Country:US
Mailing Address - Phone:925-825-8878
Mailing Address - Fax:925-825-8613
Practice Address - Street 1:400 TAYLOR BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2147
Practice Address - Country:US
Practice Address - Phone:925-825-8878
Practice Address - Fax:925-825-8613
Is Sole Proprietor?:No
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4170364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology