Basic Information
| Provider Information | |||||||||
| NPI: | 1003200734 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESHRAGH | ||||||||
| FirstName: | JASMIN | ||||||||
| MiddleName: | LILY | ||||||||
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| Credential: | C.N.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 TAYLOR BLVD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | PLEASANT HILL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945232147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9258258878 | ||||||||
| FaxNumber: | 9258258613 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 TAYLOR BLVD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | PLEASANT HILL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945232147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9258258878 | ||||||||
| FaxNumber: | 9258258613 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2015 | ||||||||
| LastUpdateDate: | 03/19/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SX0200X | 4170 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Oncology |
No ID Information.