Provider Demographics
NPI:1841568458
Name:TOWNSEND, JAZMINE VICTORIA
Entity Type:Individual
Prefix:
First Name:JAZMINE
Middle Name:VICTORIA
Last Name:TOWNSEND
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 1:13616 KORNBLUM AVE APT 13B
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-7687
Mailing Address - Country:US
Mailing Address - Phone:310-704-6921
Mailing Address - Fax:
Practice Address - Street 1:13616 KORNBLUM AVE APT 13B
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-7687
Practice Address - Country:US
Practice Address - Phone:310-704-6921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor