Healthcare Provider Details

I. General information

NPI: 1003784232
Provider Name (Legal Business Name): JASMIN PANEDA ACSW
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 MISSION ST
SAN FRANCISCO CA
94103-2626
US

IV. Provider business mailing address

1360 MISSION ST
SAN FRANCISCO CA
94103-2626
US

V. Phone/Fax

Practice location:
  • Phone: 628-217-7683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number131143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: