Provider Demographics
NPI:1952012395
Name:BERMUDEZ, JAZMIN (PA)
Entity Type:Individual
Prefix:
First Name:JAZMIN
Middle Name:
Last Name:BERMUDEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16037 NAPA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-5731
Mailing Address - Country:US
Mailing Address - Phone:818-310-6520
Mailing Address - Fax:
Practice Address - Street 1:16037 NAPA ST
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-5731
Practice Address - Country:US
Practice Address - Phone:818-310-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program