Provider Demographics
NPI:1518525716
Name:CARINO, JASMINE MENDAROS (AUD)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:MENDAROS
Last Name:CARINO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3911
Mailing Address - Country:US
Mailing Address - Phone:415-921-7658
Mailing Address - Fax:
Practice Address - Street 1:1234 DIVISADERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3911
Practice Address - Country:US
Practice Address - Phone:415-921-7658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CAAU3753237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter