Healthcare Provider Details

I. General information

NPI: 1871866848
Provider Name (Legal Business Name): CHRISTINA MARINA JASMER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA MARINA RIBAO PA-C

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SUPERIOR AVE STE 340
NEWPORT BEACH CA
92663-2772
US

IV. Provider business mailing address

1555 MESA VERDE DR E APT 23M
COSTA MESA CA
92626-5143
US

V. Phone/Fax

Practice location:
  • Phone: 949-242-3620
  • Fax:
Mailing address:
  • Phone: 949-424-3620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA54712
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9106450
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: