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NPI Code Detail

MEDICARE: JASMINE PASCUA GOZUM

MEDICARE: JASMINE PASCUA GOZUM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316717739
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE PASCUA GOZUM
Provider Business Mailing Address
First Line : 3209 L ST UNIT 5
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4351
Country : US
Telephone Number : 858-599-2671
Fax Number :
Provider Business Practice Location Address
First Line : 1011 CAMINO DEL RIO S STE 300
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3567
Country : US
Telephone Number : 619-833-3090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2024
Last Update Date : 12/08/2025

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Directions to “ JASMINE PASCUA GOZUM ” Practice Location

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