Most Relevant Information
Provider Data
| NPI Number: | 1003430349 |
| Provider Name: | JASMINE BACON MS-SLP, CCC |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 14507 |
Most Important Dates
| Enumeration Date: | 06/02/2020 |
| Last Updated: | 06/02/2020 |
Provider Practice Location
3722 KATELLA AVE STE C
LOS ALAMITOS
CA
907203102
Practice Location Phone/Fax
| Phone: | 9492918282 |
| Fax: |
Provider Mailing Location
2409 E 19TH ST
SIGNAL HILL
CA
907556001
Provider Mailing Phone/Fax
| Phone: | 9492918282 |
| Fax: |