Healthcare Provider Details

I. General information

NPI: 1023934999
Provider Name (Legal Business Name): JASMINE STANLEY-HASKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13425 VENTURA BLVD STE 200
SHERMAN OAKS CA
91423-3997
US

IV. Provider business mailing address

10726 MAGNOLIA BLVD APT 7
NORTH HOLLYWOOD CA
91601-4081
US

V. Phone/Fax

Practice location:
  • Phone: 818-877-6910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: