Individual provider Active NPI

Jasmine Chagolla, RADT

  • Addiction (Substance Use Disorder) Counselor
  • Trabuco Canyon, CA
National Provider Identifier
1255027751
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1511080623 Issued in CA
Practice address
20302 Flanagan Road
Trabuco Canyon, CA 92679
Phone
(818) 582-8836
Fax
(818) 582-8836
NPI assigned
Apr 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1511080623 CA Primary

Addresses

Primary practice location

20302 Flanagan Road
Trabuco Canyon, CA 92679

Mailing address

14530 Sylvan St
Van Nuys, CA 91411-2324
Phone (949) 690-2886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R1511080623CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Teen Project, Inc. PastSince Jun 30, 2024 Accepting new patients
The Teen Project, Inc. PastSince Nov 24, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1255027751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14530 SYLVAN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112324",
            "telephone_number": "949-690-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20302 FLANAGAN ROAD",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "92679",
            "telephone_number": "818-582-8836",
            "fax_number": "818-582-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAGOLLA",
        "first_name": "JASMINE",
        "credential": "RADT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1511080623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trabuco Canyon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.