Provider Demographics
NPI:1033940416
Name:ZARATE DOMINGUEZ, JASLYN R
Entity type:Individual
Prefix:MRS
First Name:JASLYN
Middle Name:R
Last Name:ZARATE DOMINGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JASLYN
Other - Middle Name:R
Other - Last Name:SINCLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22904 LYDEN DR UNIT 104
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-7048
Mailing Address - Country:US
Mailing Address - Phone:954-546-1016
Mailing Address - Fax:
Practice Address - Street 1:22904 LYDEN DR
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-7047
Practice Address - Country:US
Practice Address - Phone:239-696-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW219061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical