Provider Demographics
NPI:1386530129
Name:MELTON, JASMINE E (FNP-C)
Entity type:Individual
Prefix:MISS
First Name:JASMINE
Middle Name:E
Last Name:MELTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 TOWNSGATE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-5821
Mailing Address - Country:US
Mailing Address - Phone:805-379-9125
Mailing Address - Fax:805-379-2311
Practice Address - Street 1:2900 TOWNSGATE RD STE 103
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-5821
Practice Address - Country:US
Practice Address - Phone:805-379-9125
Practice Address - Fax:805-379-2311
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95125209163W00000X
CAF03250788363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse