Healthcare Provider Details

I. General information

NPI: 1871288951
Provider Name (Legal Business Name): JASMINE BAO THO NGUYEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 TREAT BLVD STE 160
WALNUT CREEK CA
94597-2168
US

IV. Provider business mailing address

1450 TREAT BLVD STE 300
WALNUT CREEK CA
94597-2168
US

V. Phone/Fax

Practice location:
  • Phone: 925-296-9000
  • Fax:
Mailing address:
  • Phone: 925-952-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A23982
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: