=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952280554
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JASMINE FLOR MORALES AUD
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2025
-----------------------------------------------------
Last Update Date | 08/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3751 BROADWAY STE B
-----------------------------------------------------
City | OAKLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94611-5613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-752-8330
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1390 GATEVIEW CT UNIT B
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94130-1234
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-975-9480
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 4079
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------