1. Home
  2. Directory
  3. California
  4. Corona
  5. Nurse Practitioner
  6. NPI Profile

JAMIE BLACK NP
NPI 1124624218
Nurse Practitioner - Family in Corona, CA

Active since December 05, 2020
4107 ADISHIAN WAY, CORONA, CA 92883(949) 302-4106 Get Directions Write a Review

NPPES record last updated: December 5, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jamie Black Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMIE BLACK NP (NPI 1124624218) is an individual family provider in Corona, California, licensed in California (95016112) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1124624218
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJAMIE BLACKCredential: NP
Location Address4107 ADISHIAN WAYCorona, CA 92883-0723
Mailing Address4107 Adishian WayCorona, CA 92883-0723 · (949) 302-4106
Phone(949) 302-4106
Sole ProprietorYes
Enumeration DateDecember 5, 2020
NPPES CertifiedDecember 5, 2020
✔ NPI 1124624218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95016112
4107 ADISHIAN WAY, Corona, CA 92883
Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jamie Black's NPI number?

The NPI number for Jamie Black is 1124624218. It was assigned to this individual provider in the NPPES registry on December 5, 2020.

Where is Jamie Black located?

Jamie Black practices at 4107 Adishian Way, Corona, CA 92883. The listed phone number is (949) 302-4106.

What is Jamie Black's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Jamie Black was last updated on December 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.