Healthcare Provider Details

I. General information

NPI: 1285482596
Provider Name (Legal Business Name): JASMIN LIM AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13925 SAN PABLO AVE STE 203
SAN PABLO CA
94806-3676
US

IV. Provider business mailing address

13925 SAN PABLO AVE STE 203
SAN PABLO CA
94806-3676
US

V. Phone/Fax

Practice location:
  • Phone: 510-525-6225
  • Fax:
Mailing address:
  • Phone: 510-338-2716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT145226
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: