Active NPI
Jazmine Abigail Rebollo
- Social Worker
- Ontario, CA
National Provider Identifier
1700564671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW123765
- Practice address
- 2940 Inland Empire Blvd
Ontario, CA 91764-4898 - Phone
- (909) 458-1350
- NPI assigned
- Jul 10, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CA | ||
| Clinical Social Worker | 1041C0700X | |||
| Social Worker | 104100000X | ASW123765 | CA | Primary |
Addresses
Primary practice location
2940 Inland Empire Blvd
Ontario, CA 91764-4898
Mailing address
2940 Inland Empire Blvd
Ontario, CA 91764-4898
Phone (909) 458-1350
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
| License | State | Type | Specialty |
|---|---|---|---|
| ASW123765 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750550400000",
"number": "1700564671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2940 INLAND EMPIRE BLVD",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917644898",
"telephone_number": "909-458-1350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 INLAND EMPIRE BLVD",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917644898",
"telephone_number": "909-458-1350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REBOLLO",
"first_name": "JAZMINE",
"middle_name": "ABIGAIL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-10",
"last_updated": "2025-06-22",
"certification_date": "2025-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW123765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.