Provider Demographics
NPI:1790533040
Name:HIGA, JASMINE PUALEILANI (DPT)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:PUALEILANI
Last Name:HIGA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5075 S BRADLEY RD STE 121
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5077
Mailing Address - Country:US
Mailing Address - Phone:805-934-0663
Mailing Address - Fax:
Practice Address - Street 1:5075 S BRADLEY RD STE 121
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5077
Practice Address - Country:US
Practice Address - Phone:805-934-0663
Practice Address - Fax:805-332-3409
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist