MEDICARE: JASMINE ESTRADA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker		CA

General Provider Information

NPI Number	:	1285424630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE ESTRADA

Provider Business Mailing Address
First Line	:	3350 SHELBY ST STE 200
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91764-5556
Country	:	US
Telephone Number	:	909-202-4572
Fax Number	:

Provider Business Practice Location Address
First Line	:	11860 TELEPHONE AVE.
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710
Country	:	US
Telephone Number	:	909-202-4572
Fax Number	:	909-775-1992

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2025
Last Update Date	:	03/12/2026

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Directions to “ JASMINE ESTRADA ” Practice Location

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