Healthcare Provider Details

I. General information

NPI: 1033028345
Provider Name (Legal Business Name): JASMINE TAYLOR ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 S RIVER ST STE 203
SANTA CRUZ CA
95060-4540
US

IV. Provider business mailing address

147 S RIVER ST STE 203
SANTA CRUZ CA
95060-4540
US

V. Phone/Fax

Practice location:
  • Phone: 831-588-8032
  • Fax:
Mailing address:
  • Phone: 831-588-8032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number115511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: