Provider Demographics
NPI:1700563988
Name:XIONG, JASINE
Entity Type:Individual
Prefix:
First Name:JASINE
Middle Name:
Last Name:XIONG
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 1:7674 LINDSEY CT
Mailing Address - Street 2:
Mailing Address - City:WINTON
Mailing Address - State:CA
Mailing Address - Zip Code:95388-9270
Mailing Address - Country:US
Mailing Address - Phone:209-761-1237
Mailing Address - Fax:
Practice Address - Street 1:7674 LINDSEY CT
Practice Address - Street 2:
Practice Address - City:WINTON
Practice Address - State:CA
Practice Address - Zip Code:95388-9270
Practice Address - Country:US
Practice Address - Phone:209-761-1237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer