Healthcare Provider Details

I. General information

NPI: 1780514133
Provider Name (Legal Business Name): JASMIN VASQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 ROBERTS LN STE A
BAKERSFIELD CA
93308-4723
US

IV. Provider business mailing address

661 ROBERTS LN STE A
BAKERSFIELD CA
93308-4723
US

V. Phone/Fax

Practice location:
  • Phone: 661-322-1021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number138187
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: