Provider Demographics
NPI:1932953361
Name:BAINS CLAIR, JASMEEN
Entity Type:Individual
Prefix:
First Name:JASMEEN
Middle Name:
Last Name:BAINS CLAIR
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 1:1010 WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:WHEATLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95692-9798
Mailing Address - Country:US
Mailing Address - Phone:530-633-3100
Mailing Address - Fax:
Practice Address - Street 1:1010 WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:WHEATLAND
Practice Address - State:CA
Practice Address - Zip Code:95692-9798
Practice Address - Country:US
Practice Address - Phone:530-633-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200003700103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool