Healthcare Provider Details

I. General information

NPI: 1871259119
Provider Name (Legal Business Name): JASMINE MONCERRAT BUGARIN ESPARZA NONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2021
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18726 S WESTERN AVE
GARDENA CA
90248-3813
US

IV. Provider business mailing address

6833 STOCKTON BLVD STE 485
SACRAMENTO CA
95823-2376
US

V. Phone/Fax

Practice location:
  • Phone: 310-856-0800
  • Fax: 855-568-2494
Mailing address:
  • Phone: 916-942-9060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number136302
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: