Individual
JASMYNE RICHMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1570 164TH AVE, SAN LEANDRO, CA 94578-2286
(619) 788-6794
(619) 788-6794
Mailing address
1570 164TH AVE, SAN LEANDRO, CA 94578-2286
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
CA
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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