Healthcare Provider Details

I. General information

NPI: 1972407815
Provider Name (Legal Business Name): JASMIN BARAJAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 E RINCON ST STE 100
CORONA CA
92879-1306
US

IV. Provider business mailing address

PO BOX 33038
RIVERSIDE CA
92519-0038
US

V. Phone/Fax

Practice location:
  • Phone: 888-662-9378
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number142227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: