Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacquelyn Smith-Douglas, FNP

Individual provider Nurse Practitioner · NPI 1598336828

Jacquelyn Smith-Douglas, FNP is a Nurse Practitioner in Costa Mesa, California. Qualified in 2019, 7 years ago. Practices with Vital Medical Group Inc, an 8-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2021
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

150 Paularino Ave
Costa Mesa, CA 92626-3301
Phone: (949) 556-3433
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8850 Valley View St, Buena Park, CA 90620-3562 — (323) 251-0477

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence F07210327 (CA)

Record details

NPI number1598336828
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorYes
NPI enumeratedJuly 7, 2021
Last updated in NPPESDecember 29, 2022
Certification dateDecember 29, 2022
Mailing address8441 Renwick Dr, Corona, CA 92883-5931

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Vital Medical Group Inc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Costa Mesa