Healthcare Provider Details

I. General information

NPI: 1770412470
Provider Name (Legal Business Name): RUBY JASMINE FLOWERS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25528 BIRCHTREE DR
MURRIETA CA
92563-5372
US

IV. Provider business mailing address

25528 BIRCHTREE DR
MURRIETA CA
92563-5372
US

V. Phone/Fax

Practice location:
  • Phone: 951-719-6577
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number36479
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: