Healthcare Provider Details

I. General information

NPI: 1982532677
Provider Name (Legal Business Name): JASMINE ALICIA TENORIO MONROY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MANSELL ST
SAN FRANCISCO CA
94134-1829
US

IV. Provider business mailing address

475 ORIZABA AVE
SAN FRANCISCO CA
94132-2824
US

V. Phone/Fax

Practice location:
  • Phone: 415-469-4550
  • Fax:
Mailing address:
  • Phone: 415-240-6983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: