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JASMINE SOURIVONG
NPI 1215655311
Specialist in Stockton, CA

Active since August 16, 2022
2185 W ROSE ST, STOCKTON, CA 95203(510) 593-1835 Get Directions Write a Review

NPPES record last updated: August 16, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jasmine Sourivong NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JASMINE SOURIVONG (NPI 1215655311) is an individual specialist in Stockton, California and active in the NPI registry since August 2022.

NPPES Registry Identity

NPI1215655311
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameJASMINE SOURIVONG
Location Address2185 W ROSE STStockton, CA 95203-1208
Mailing Address7200 Bancroft Ave Ste 267Oakland, CA 94605-2403 · (510) 593-1835
Phone(510) 593-1835
Sole ProprietorYes
Enumeration DateAugust 16, 2022
NPPES CertifiedAugust 16, 2022
✔ NPI 1215655311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2185 W ROSE ST, Stockton, CA 95203
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jasmine Sourivong's NPI number?

The NPI number for Jasmine Sourivong is 1215655311. It was assigned to this individual provider in the NPPES registry on August 16, 2022.

Where is Jasmine Sourivong located?

Jasmine Sourivong practices at 2185 W Rose St, Stockton, CA 95203. The listed phone number is (510) 593-1835.

What is Jasmine Sourivong's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Jasmine Sourivong was last updated on August 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.