Provider Demographics
NPI:1184109894
Name:AMARO, JAZMIN (JAZMIN)
Entity type:Individual
Prefix:
First Name:JAZMIN
Middle Name:
Last Name:AMARO
Suffix:
Gender:F
Credentials:JAZMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 TELEPHONE RD STE 117
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5672
Mailing Address - Country:US
Mailing Address - Phone:805-978-2075
Mailing Address - Fax:
Practice Address - Street 1:4601 TELEPHONE RD STE 117
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5672
Practice Address - Country:US
Practice Address - Phone:805-978-2075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program