Provider Demographics
NPI:1316373152
Name:SIMARRO, JASMINE ANNE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:ANNE
Last Name:SIMARRO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:JASMINE
Other - Middle Name:ANNE
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:4200 SPAULDING ST
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8220
Mailing Address - Country:US
Mailing Address - Phone:805-320-8341
Mailing Address - Fax:
Practice Address - Street 1:1928 SAINT MARYS RD
Practice Address - Street 2:
Practice Address - City:MORAGA
Practice Address - State:CA
Practice Address - Zip Code:94575-2715
Practice Address - Country:US
Practice Address - Phone:574-229-8125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23758363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily