Provider Demographics
NPI:1679882112
Name:HAMILTON, JASMINE JOYCE (CNA)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:JOYCE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163301
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-9301
Mailing Address - Country:US
Mailing Address - Phone:916-498-4202
Mailing Address - Fax:
Practice Address - Street 1:3425 MARTIN LUTHER KING JR BLVD RM F
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-3648
Practice Address - Country:US
Practice Address - Phone:916-498-4202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00762835163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00762835Medicare PIN