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NPI Code Detail

MEDICARE: MR. TERRY MAURICE JASPER JR.

MEDICARE:  MR. TERRY MAURICE JASPER JR.
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)NM
2261QM0850XAdult Mental Health Clinic/CenterNM
3261QM0855XAdolescent and Children Mental Health Clinic/CenterNM
4104100000XSocial WorkerSWB-2024-0076NM

General Provider Information

NPI Number : 1518808997
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TERRY MAURICE JASPER JR.
Provider Business Mailing Address
First Line : 95-061 KAULUA ST
Second Line :
City : MILILANI
State : HI
Zip : 96789-1509
Country : US
Telephone Number : 808-489-3007
Fax Number :
Provider Business Practice Location Address
First Line : 3308 OASIS SPRINGS RD NE
Second Line :
City : RIO RANCHO
State : NM
Zip : 87144-2579
Country : US
Telephone Number : 808-489-3007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2026
Last Update Date : 04/01/2026

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