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Jasmine Sourivong
Specialist in Stockton, California
NPI 1215655311

Jasmine Sourivong is a Specialist based in Oakland, CA. Jasmine Sourivong practices in Stockton, CA. The NPI Number for Jasmine Sourivong is 1215655311 and holds a License No. (California).

The current practice location address for Jasmine Sourivong is 2185 W Rose St, Stockton, CA and can be reached out via phone at 510-593-1835. You can also correspond with Jasmine Sourivong through the mailing address at 7200 BANCROFT AVE STE 267, OAKLAND, CA - 94605-2403 (mailing address contact number: 510-593-1835).

Location: 2185 W Rose St, Stockton, CA, 94605-2403
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215655311
Provider Name
Jasmine Sourivong
Credential
Provider Entity Type
Individual
Gender
Female
Address
2185 W Rose St, Stockton, CA, 94605-2403
Phone Number
510-593-1835
Fax Number
Provider Enumeration Date
08/16/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2185 W Rose St
City
Stockton
State
California
Zip
95203-1208
Phone Number
510-593-1835
Fax Number
person
Provider Business Mailing Address Details
Address
2185 W Rose St
City
Stockton
State
California
Zip
95203-1208
Phone Number
510-593-1835
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
(California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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