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General NPI Number Information
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NPI Number | 1558842674
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Entity Type | Individual
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Provider Name | JASMINE MANALO
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Gender | Female
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 01/25/2020
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Provider Practice Location Address
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Address Line | 195 GLEN COVE MARINA RD E STE 200
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City | VALLEJO
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State | CA
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Zip | 94591-7291
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Country | US
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Telephone | 707-651-9915
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Fax |
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Provider Business Mailing Address
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Address Line | 307 BENTON WAY
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City | AMERICAN CANYON
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State | CA
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Zip | 94503-1146
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Country | US
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Telephone | 650-892-9540
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 4306
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License Number State | CA
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