LASHAUNDA RENEE JETHRO PMHNP DNP NPI 1497325187

NPI Information

  • NPI: 1497325187
  • Provider Name: LASHAUNDA RENEE JETHRO, PMHNP, DNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4290 POLK AVE
    SAN DIEGO, CA
    ZIP 92105
  • Phone: (619) 563-0250

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NPI Details

Lashaunda Renee Jethro, PMHNP, DNP is a psychiatric/mental health nurse practitioner in San Diego, CA with 5 years of experience. Lashaunda Renee Jethro, PMHNP, DNP NPI is 1497325187. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4290 POLK AVE
SAN DIEGO, CA
ZIP 92105-524
Phone: (619) 563-0250
Fax: (858) 633-4681

The NPI 1497325187 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/25/2021 and was last updated on 8/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthNP95017852CALIFORNIAYes
2163W00000XRegistered Nurse95127420CALIFORNIANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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