Provider Demographics
NPI:1851823645
Name:JAYME, ANA JASMINE LABINDALAWA
Entity Type:Individual
Prefix:
First Name:ANA JASMINE
Middle Name:LABINDALAWA
Last Name:JAYME
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 1:520 S LA FAYETTE PARK PL STE 300
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-5400
Mailing Address - Country:US
Mailing Address - Phone:213-252-2100
Mailing Address - Fax:
Practice Address - Street 1:520 S LA FAYETTE PARK PL STE 300
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-5400
Practice Address - Country:US
Practice Address - Phone:213-252-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF88147106H00000X
CALMFT116890106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist