Healthcare Provider Details

I. General information

NPI: 1699680496
Provider Name (Legal Business Name): JAZMIN QUINONEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1965 BIRKMONT DR
RANCHO CORDOVA CA
95742-6407
US

IV. Provider business mailing address

9750 OLD PLACERVILLE RD APT 29
SACRAMENTO CA
95827-3351
US

V. Phone/Fax

Practice location:
  • Phone: 926-294-9025
  • Fax:
Mailing address:
  • Phone: 714-486-4152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberB4BEF8BD73
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: