Provider Demographics
NPI:1275997637
Name:SINGH, JASMINE MALIKA (DO)
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:MALIKA
Last Name:SINGH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 N CALIFORNIA ST STE A
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5533
Mailing Address - Country:US
Mailing Address - Phone:213-375-8095
Mailing Address - Fax:
Practice Address - Street 1:2216 N CALIFORNIA ST
Practice Address - Street 2:STE A
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5533
Practice Address - Country:US
Practice Address - Phone:213-375-8095
Practice Address - Fax:610-273-5687
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA20A158832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program