MEDICARE: JASMINE AVILES MS CCC-SLP

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	235Z00000X	Speech-Language Pathologist	20609	CA

General Provider Information

NPI Number	:	1891675831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE AVILES MS CCC-SLP

Provider Business Mailing Address
First Line	:	2175 ROAN CT
Second Line	:
City	:	LIVERMORE
State	:	CA
Zip	:	94551-5423
Country	:	US
Telephone Number	:	650-255-4581
Fax Number	:

Provider Business Practice Location Address
First Line	:	1475 HARLAN DR
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-5248
Country	:	US
Telephone Number	:	925-855-5338
Fax Number	:

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

Provider Enumeration Date	:	09/02/2025
Last Update Date	:	09/02/2025

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Directions to “ JASMINE AVILES MS CCC-SLP” Practice Location

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