Provider Demographics
NPI:1518450329
Name:FLANIGAN, JASMINE LOUISE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:LOUISE
Last Name:FLANIGAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LOVE CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:CA
Mailing Address - Zip Code:94930-1312
Mailing Address - Country:US
Mailing Address - Phone:707-489-6933
Mailing Address - Fax:
Practice Address - Street 1:1944 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2745
Practice Address - Country:US
Practice Address - Phone:415-562-4047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT86595106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist