Individual provider Active NPI

Jasmin Ceron, MT

  • Massage Therapist
  • Clovis, CA
National Provider Identifier
1417614017
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
86372 Issued in CA
Practice address
3097 Willow Ave Ste 20
Clovis, CA 93612-4715
Phone
(559) 387-4582
NPI assigned
Nov 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 86372 CA Primary

Addresses

Primary practice location

3097 Willow Ave Ste 20
Clovis, CA 93612-4715

Mailing address

3097 Willow Ave Ste 20
Clovis, CA 93612-4715
Phone (559) 387-4582

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
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
86372CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1417614017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3097 WILLOW AVE STE 20",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936124715",
            "telephone_number": "559-387-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3097 WILLOW AVE STE 20",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936124715",
            "telephone_number": "559-387-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERON",
        "first_name": "JASMIN",
        "credential": "MT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "86372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.