Individual provider Active NPI

Jazmin Cristal Ibarra

  • Student in an Organized Health Care Education/Training Program
  • Long Beach, CA
National Provider Identifier
1649963612
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
5190 Atlantic Ave
Long Beach, CA 90805-6510
Phone
(562) 428-4111
NPI assigned
May 26, 2023
Last updated
Jul 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA Primary
Peer Specialist 175T00000X NU

Addresses

Primary practice location

5190 Atlantic Ave
Long Beach, CA 90805-6510

Mailing address

5190 Atlantic Ave
Long Beach, CA 90805-6510
Phone (562) 428-4111

Other practice location 1

849 E 6th St
Los Angeles, CA 90021-1026
Phone (213) 623-8446 ext. 217

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

NPI Registry JSON

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

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1649963612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908056510",
            "telephone_number": "562-428-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908056510",
            "telephone_number": "562-428-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "849 E 6th St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900211026",
            "country_code": "US",
            "telephone_number": "213-623-8446 x217",
            "fax_number": "213-896-1880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBARRA",
        "first_name": "JAZMIN",
        "middle_name": "CRISTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-26",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.