JACKIE D. FOREMAN FNP NPI 1972547735

NPI Information

  • NPI: 1972547735
  • Provider Name: JACKIE D. FOREMAN, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 731 S AVENUE 59
    LOS ANGELES, CA
    ZIP 90042
  • Phone: (620) 875-6462

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NPI Details

Jackie D. Foreman, FNP is a family nurse practitioner in Los Angeles, CA. Jackie D. Foreman, FNP NPI is 1972547735. 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:

731 S AVENUE 59
LOS ANGELES, CA
ZIP 90042-003
Phone: (620) 875-6462

The enumeration date for this NPI number is 6/15/2006 and was last updated on 4/6/2011.

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
1363L00000XNurse Practitioner139057MISSOURINo
2363LF0000XNurse PractitionerFamilyNP 19781CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P10475MEDICARE UPIN
2110135001MEDICARE PINKANSAS

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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