Healthcare Provider Details

I. General information

NPI: 1982415535
Provider Name (Legal Business Name): JASMINE ROBLEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E 7TH ST
MADERA CA
93638-3780
US

IV. Provider business mailing address

317 S H ST APT 4
MADERA CA
93637-3525
US

V. Phone/Fax

Practice location:
  • Phone: 559-395-0451
  • Fax:
Mailing address:
  • Phone: 559-613-7597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: