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General NPI Number Information
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NPI Number | 1417590886
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Entity Type | Individual
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Provider Name | JASMINE L HENDRIX
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Gender | Female
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Dates
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Enumeration Date | 10/17/2019
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 8300 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90044-3493
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Country | US
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Telephone | 323-525-6413
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 662165
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City | LOS ANGELES
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State | CA
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Zip | 90066-8565
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Country | US
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Telephone | 310-993-4956
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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 | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 32820
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 32820
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License Number State | CA
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