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General NPI Number Information
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NPI Number | 1710854906
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Entity Type | Individual
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Provider Name | JASMINE JENAL IBARRA MS
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Gender | Female
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 300 S PARK AVE
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City | POMONA
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State | CA
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Zip | 91766-1501
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Country | US
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Telephone | 909-764-0212
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Fax |
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Provider Business Mailing Address
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Address Line | 868 S DUFF AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-4174
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Country | US
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Telephone | 626-715-2285
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | CA
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