Provider Demographics
NPI:1043943525
Name:OKAFOR, JASMINE PAUTHENA (LMT)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:PAUTHENA
Last Name:OKAFOR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15030 VENTURA BLVD # 295
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5470
Mailing Address - Country:US
Mailing Address - Phone:888-890-0043
Mailing Address - Fax:818-698-3900
Practice Address - Street 1:21601 VANOWEN ST STE 207
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-2753
Practice Address - Country:US
Practice Address - Phone:888-890-0043
Practice Address - Fax:818-698-3900
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-02
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80067225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty