Healthcare Provider Details

I. General information

NPI: 1285590588
Provider Name (Legal Business Name): JASMIN BARAHONA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 EMPIRE ST
FAIRFIELD CA
94533-5562
US

IV. Provider business mailing address

744 EMPIRE ST
FAIRFIELD CA
94533-5562
US

V. Phone/Fax

Practice location:
  • Phone: 415-474-7310
  • Fax:
Mailing address:
  • Phone: 415-474-7310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number698664
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: