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General NPI Number Information
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NPI Number | 1922668664
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Entity Type | Individual
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Provider Name | JASMINE NYCOLE CHARLES ASW
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Gender | Female
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 10802 COLLEGE PL
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City | CERRITOS
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State | CA
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Zip | 90703-1505
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Country | US
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Telephone | 562-924-9581
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Fax |
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Provider Business Mailing Address
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Address Line | 16811 TAMARIND CT
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City | CHINO HILLS
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State | CA
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Zip | 91709-6511
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Country | US
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Telephone | 562-665-3370
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 83661
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License Number State | CA
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