Healthcare Provider Details

I. General information

NPI: 1871407858
Provider Name (Legal Business Name): JAZMYNE SEPEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24500 ROAD 68
TULARE CA
93274-9607
US

IV. Provider business mailing address

1583 E CYPRESS AVE
TULARE CA
93274-8412
US

V. Phone/Fax

Practice location:
  • Phone: 559-688-2908
  • Fax:
Mailing address:
  • Phone: 559-688-2908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number230130737
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: