Individual
JASMIN BAHENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
817 W WESTWAY AVE, ORANGE, CA 92865-2533
(000) 000-0000
Mailing address
2102 S GREENVILLE ST, SANTA ANA, CA 92704-4521
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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