Provider Demographics
NPI:1588075253
Name:JONES, JASMIN A (MSTOM LAC)
Entity type:Individual
Prefix:MS
First Name:JASMIN
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:MSTOM LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 MONTGOMERY DR
Mailing Address - Street 2:L-6
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405
Mailing Address - Country:US
Mailing Address - Phone:707-227-4950
Mailing Address - Fax:
Practice Address - Street 1:4000 MONTGOMERY DR
Practice Address - Street 2:L-6
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405
Practice Address - Country:US
Practice Address - Phone:707-227-4950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK157171100000X
HIACU-1073171100000X
CA19434171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist