Provider Demographics
NPI:1013690478
Name:HIEMER, JAZMIN ALEJANDRA
Entity Type:Individual
Prefix:
First Name:JAZMIN
Middle Name:ALEJANDRA
Last Name:HIEMER
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 1:4212 ARCHWAY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-8830
Mailing Address - Country:US
Mailing Address - Phone:714-814-6560
Mailing Address - Fax:
Practice Address - Street 1:4212 ARCHWAY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-8830
Practice Address - Country:US
Practice Address - Phone:714-814-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program