Provider Demographics
NPI:1487316469
Name:JASMINE, PHOENIX NOEL (LMFT)
Entity type:Individual
Prefix:MRS
First Name:PHOENIX
Middle Name:NOEL
Last Name:JASMINE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:PHOENIX
Other - Middle Name:NOEL
Other - Last Name:HOOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1031 SUSANA CT
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-4629
Mailing Address - Country:US
Mailing Address - Phone:817-807-5301
Mailing Address - Fax:
Practice Address - Street 1:2382 FARADAY AVE
Practice Address - Street 2:SUITE 200- 18
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008
Practice Address - Country:US
Practice Address - Phone:442-264-7188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147271106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist