Healthcare Provider Details

I. General information

NPI: 1922938117
Provider Name (Legal Business Name): BARBARA Y JARAMILLO
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 CALLE PUENTE
SAN CLEMENTE CA
92672-5019
US

IV. Provider business mailing address

1101 CALLE PUENTE
SAN CLEMENTE CA
92672-5019
US

V. Phone/Fax

Practice location:
  • Phone: 949-234-5333
  • Fax:
Mailing address:
  • Phone: 949-234-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number250151149
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: