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Individual

JASMINE CHASTITY MIMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
24904 LEAR LN, MORENO VALLEY, CA 92553-5875
(661) 742-4026
Mailing address
24904 LEAR LN, MORENO VALLEY, CA 92553-5875
(661) 742-4026

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
13628
CA
101Y00000X
Counselor
21581
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YP2500X
Professional Counselor
Primary
13628
CA
101YP2500X
Professional Counselor
Primary
21581
CA
104100000X
Social Worker
13628
CA
104100000X
Social Worker
21581
CA

Other

Enumeration date
01/11/2021
Last updated
05/01/2026
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