MEDICARE: JASMYNNE SPENCE

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	1041C0700X	Clinical Social Worker	10252-C	NV
2	104100000X	Social Worker
3	101YM0800X	Mental Health Counselor
4	171M00000X	Case Manager/Care Coordinator
5	1041C0700X	Clinical Social Worker	C019255	NC
6	1041C0700X	Clinical Social Worker	130222	CA
7	1041C0700X	Clinical Social Worker	117578	TX

General Provider Information

NPI Number	:	1528612025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMYNNE SPENCE

Provider Business Mailing Address
First Line	:	2050 N TUSTIN ST # 1016
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92865-3902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	736 E WHITECAP AVE
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92865-1831
Country	:	US
Telephone Number	:	714-277-8981
Fax Number	:

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

Provider Enumeration Date	:	08/01/2019
Last Update Date	:	03/15/2026

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Directions to “ JASMYNNE SPENCE ” Practice Location

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