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NPI Code Detail

MEDICARE: JASMINE LANDIS

MEDICARE: JASMINE LANDIS
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
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1598612830
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE LANDIS
Provider Business Mailing Address
First Line : 3652 MICHELSON DR
Second Line :
City : IRVINE
State : CA
Zip : 92612-1727
Country : US
Telephone Number : 949-474-1493
Fax Number :
Provider Business Practice Location Address
First Line : 3652 MICHELSON DR
Second Line :
City : IRVINE
State : CA
Zip : 92612-1727
Country : US
Telephone Number : 949-474-1493
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Practice Location Address:
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Directions to “ JASMINE LANDIS ” Practice Location

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