Jasmin Collazo, LMFT
Individual provider Active NPI Marriage & Family Therapist · Marina, CA
NPI 1053545178 · NPPES record last updated Dec 1, 2022
Key facts
- NPI
- 1053545178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 90541 (CA)
- Practice address
- 3160 Shuler Cir
Marina, CA 93933-2755 - Phone
- (650) 576-1074
- NPI assigned
- May 4, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90541 | CA | MD | Marriage & Family Therapist |
Interoperability endpoints
- lifestancehealth.jasminjourdenais@148377.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | |||
| Marriage & Family Therapist | 106H00000X | 90541 | CA | Yes |
Addresses
Primary practice location
3160 Shuler Cir
Marina, CA 93933-2755
Mailing address
3160 Shuler Cir
Marina, CA 93933-2755
Phone (650) 576-1074
Other names
- Jasmin Jourdenais
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | PCPAEMR | Health Information Exchange (HIE) |
Other providers in Marina, CA
- Helen Cifuentes
- Amber S Clayton
- Jolene Carol Coe
- Casey E Cohen
- Doron Cohen
- David Conow
- Yadira Sarai Contreras
- Richard Alan Corcoran
- Amy B. Cornell
- Sonia Cortes
All providers in Marina, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.