Provider Demographics
NPI:1760360317
Name:CHAPA, JASMINE B
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:B
Last Name:CHAPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49245 BALADA CT
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2446
Mailing Address - Country:US
Mailing Address - Phone:760-397-7638
Mailing Address - Fax:
Practice Address - Street 1:150 DISTRICT CENTER DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-3626
Practice Address - Country:US
Practice Address - Phone:760-883-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95119632163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool