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General NPI Number Information
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NPI Number | 1023977089
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Entity Type | Organization
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Legal Business Name | JASMINE FOMBONA
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 2525 N CHESTER AVE STE C
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City | BAKERSFIELD
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State | CA
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Zip | 93308-1770
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Country | US
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Telephone | 661-868-1840
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 N CHESTER AVE STE C
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City | BAKERSFIELD
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State | CA
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Zip | 93308-1770
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Country | US
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Telephone | 661-868-1840
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Fax |
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Authorized Official
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Title or Position | STUDENT INTERN
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Name | JASMINE FOMBONA
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Credential | BACHELORS
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Telephone | 661-340-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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