Healthcare Provider Details

I. General information

NPI: 1972423945
Provider Name (Legal Business Name): JASMINE ALANA SWALLOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2407 WILSHIRE BLVD
SANTA MONICA CA
90403-5805
US

IV. Provider business mailing address

1832 OLD ORCHARD RD
LOS ANGELES CA
90049-2231
US

V. Phone/Fax

Practice location:
  • Phone: 310-882-9955
  • Fax:
Mailing address:
  • Phone: 310-882-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number309759
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: