MEDICARE: JASMINE JOETTE CEDENO

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	106H00000X	Marriage & Family Therapist	AMFT117401	CA

General Provider Information

NPI Number	:	1477297760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE JOETTE CEDENO

Provider Business Mailing Address
First Line	:	115 PINE AVE STE 440
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-4457
Country	:	US
Telephone Number	:	562-432-0088
Fax Number	:	562-432-0089

Provider Business Practice Location Address
First Line	:	115 PINE AVE STE 440
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-4457
Country	:	US
Telephone Number	:	562-248-9409
Fax Number	:	562-432-0089

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

Provider Enumeration Date	:	04/23/2022
Last Update Date	:	04/23/2022

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Directions to “ JASMINE JOETTE CEDENO ” Practice Location

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