Healthcare Provider Details

I. General information

NPI: 1699686139
Provider Name (Legal Business Name): JASMINE ELIZABETH ENRIQUEZ CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

273 E BEVERLY BLVD
MONTEBELLO CA
90640-3775
US

IV. Provider business mailing address

12830 OCASO AVE
LA MIRADA CA
90638-2419
US

V. Phone/Fax

Practice location:
  • Phone: 323-724-5100
  • Fax:
Mailing address:
  • Phone: 562-217-7089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: