MEDICARE: JASMIN GONZALEZ

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
1	225XP0200X	Pediatric Occupational Therapist		CA
2	225XP0200X	Pediatric Occupational Therapist	25686	CA

General Provider Information

NPI Number	:	1730952797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMIN GONZALEZ

Provider Business Mailing Address
First Line	:	1815 W 213TH ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90501-2800
Country	:	US
Telephone Number	:	310-328-0276
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 W 213TH ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90501-2800
Country	:	US
Telephone Number	:	310-328-0276
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	04/06/2026

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Directions to “ JASMIN GONZALEZ ” Practice Location

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