Provider Demographics
NPI:1558125682
Name:ASABERE, JASON ASANTE
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ASANTE
Last Name:ASABERE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14609 FREEMAN AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-1652
Mailing Address - Country:US
Mailing Address - Phone:310-948-5230
Mailing Address - Fax:
Practice Address - Street 1:14609 FREEMAN AVE APT 7
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-1652
Practice Address - Country:US
Practice Address - Phone:310-948-5230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA142696106H00000X
CA15055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health