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JACKIE D. FOREMAN FNP
NPI 1972547735
Nurse Practitioner - Family in Los Angeles, CA

Active since June 15, 2006
731 S AVENUE 59, LOS ANGELES, CA 90042(620) 875-6462 Get Directions Write a Review

NPPES record last updated: April 6, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jackie D. Foreman Fnp NPPES

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

JACKIE D. FOREMAN FNP (NPI 1972547735) is an individual family provider in Los Angeles, California, licensed in California (NP 19781) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1972547735
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJACKIE D. FOREMANCredential: FNP
Location Address731 S AVENUE 59Los Angeles, CA 90042-5003
Mailing Address731 S Avenue 59Los Angeles, CA 90042-5003 · (620) 875-6462
Phone(620) 875-6462
Sole ProprietorNo
Enumeration DateJune 15, 2006
Last NPPES UpdateApril 6, 2011
✔ NPI 1972547735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · NP 19781
Also ListedNurse PractitionerTaxonomy 363L00000X · License 139057 (MO)
731 S AVENUE 59, Los Angeles, CA 90042
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Other Identifiers 2

Medicare UPINP10475
Medicare PIN110135001KS

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 Jackie Foreman's NPI number?

The NPI number for Jackie Foreman is 1972547735. It was assigned to this individual provider in the NPPES registry on June 15, 2006.

Where is Jackie Foreman located?

Jackie Foreman practices at 731 S Avenue 59, Los Angeles, CA 90042. The listed phone number is (620) 875-6462.

What is Jackie Foreman'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 Jackie Foreman was last updated on April 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.