Healthcare Provider Details

I. General information

NPI: 1063342186
Provider Name (Legal Business Name): MISS JAZMINE SHELTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8383 WILSHIRE BLVD STE 50
BEVERLY HILLS CA
90211-2430
US

IV. Provider business mailing address

1727 4TH AVE APT 4
LOS ANGELES CA
90019-6137
US

V. Phone/Fax

Practice location:
  • Phone: 310-909-7252
  • Fax:
Mailing address:
  • Phone: 310-909-7252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number85840
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: