Healthcare Provider Details

I. General information

NPI: 1538607601
Provider Name (Legal Business Name): JASMIN KIRVIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2017
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 SANTIAGO ST
SAN FRANCISCO CA
94116-1526
US

IV. Provider business mailing address

2321 CHINA LN
FAIRFIELD CA
94534-7502
US

V. Phone/Fax

Practice location:
  • Phone: 415-695-5691
  • Fax:
Mailing address:
  • Phone: 510-289-2189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number25338
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: