Healthcare Provider Details

I. General information

NPI: 1669353355
Provider Name (Legal Business Name): JASMINE NEVAREZ MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E CHAPMAN AVE STE 203
FULLERTON CA
92831-3846
US

IV. Provider business mailing address

PO BOX 919
FULLERTON CA
92836-0919
US

V. Phone/Fax

Practice location:
  • Phone: 714-680-9000
  • Fax: 714-690-8233
Mailing address:
  • Phone: 714-680-9000
  • Fax: 714-680-8233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: