Healthcare Provider Details

I. General information

NPI: 1144802166
Provider Name (Legal Business Name): JAZMYN JENEE HALLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

494 BLOSSOM WAY
CHERRYLAND CA
94541-1948
US

IV. Provider business mailing address

24292 ALVES ST
HAYWARD CA
94544-1513
US

V. Phone/Fax

Practice location:
  • Phone: 510-582-7676
  • Fax:
Mailing address:
  • Phone: 510-862-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number125162
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: