Healthcare Provider Details

I. General information

NPI: 1902780760
Provider Name (Legal Business Name): JASSMIN ADELY CEDILLO M.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JASSMIN ADELY ROJAS M.S.

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8887 PALMETTO AVE
FONTANA CA
92335-4939
US

IV. Provider business mailing address

8887 PALMETTO AVE
FONTANA CA
92335-4939
US

V. Phone/Fax

Practice location:
  • Phone: 951-232-2503
  • Fax:
Mailing address:
  • Phone: 909-676-1257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: