Provider Demographics
NPI:1184033961
Name:HORNE, JASMINDA (LCSW)
Entity Type:Individual
Prefix:
First Name:JASMINDA
Middle Name:
Last Name:HORNE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1532
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955
Mailing Address - Country:US
Mailing Address - Phone:831-582-8527
Mailing Address - Fax:
Practice Address - Street 1:HWY 101 5 MILES NORTH OF SOLEDAD
Practice Address - Street 2:
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93906
Practice Address - Country:US
Practice Address - Phone:831-678-3951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA847151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program