Provider Demographics
NPI:1922584713
Name:TIRADO, JASMIN ISABEL I
Entity Type:Individual
Prefix:MS
First Name:JASMIN
Middle Name:ISABEL
Last Name:TIRADO
Suffix:I
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 1:1515 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-2875
Mailing Address - Country:US
Mailing Address - Phone:415-424-8244
Mailing Address - Fax:
Practice Address - Street 1:1515 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-2875
Practice Address - Country:US
Practice Address - Phone:415-424-8244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-14
Last Update Date:2018-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst