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General NPI Number Information
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NPI Number | 1073331500
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Entity Type | Individual
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Provider Name | JAZMIN PALACIOS PEGUERO PPS
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Gender | Female
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 248 W A ST
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City | GALT
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State | CA
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Zip | 95632-2449
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Country | US
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Telephone | 209-745-2641
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Fax |
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Provider Business Mailing Address
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Address Line | 2467 E SONORA ST
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City | STOCKTON
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State | CA
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Zip | 95205-6508
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Country | US
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Telephone | 209-623-3204
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 240131502
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License Number State | CA
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