Provider Demographics
NPI:1437832995
Name:HARDY, JASMINE ZOE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:ZOE
Last Name:HARDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 GLADYS AVE APT I
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3787
Mailing Address - Country:US
Mailing Address - Phone:661-713-5311
Mailing Address - Fax:
Practice Address - Street 1:1075 GLADYS AVE APT I
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3787
Practice Address - Country:US
Practice Address - Phone:661-713-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer