Provider Demographics
NPI:1477297760
Name:CEDENO, JASMINE JOETTE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:JOETTE
Last Name:CEDENO
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 1:115 PINE AVE STE 440
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4457
Mailing Address - Country:US
Mailing Address - Phone:562-432-0088
Mailing Address - Fax:562-432-0089
Practice Address - Street 1:115 PINE AVE STE 440
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4457
Practice Address - Country:US
Practice Address - Phone:562-248-9409
Practice Address - Fax:562-432-0089
Is Sole Proprietor?:No
Enumeration Date:2022-04-23
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT117401106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist