Provider Demographics
NPI:1730996927
Name:SALONGA, JASMINE PALAFOX
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:PALAFOX
Last Name:SALONGA
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 1:319 AVENUE C APT MH
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1642
Mailing Address - Country:US
Mailing Address - Phone:805-901-8191
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE RM 1103
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6668
Practice Address - Country:US
Practice Address - Phone:646-504-5086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124400-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker