Provider Demographics
NPI:1144065780
Name:KONO-SONG, JASMINE M
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:M
Last Name:KONO-SONG
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 1:901 W VICTORIA ST STE F&G
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-5807
Mailing Address - Country:US
Mailing Address - Phone:310-669-9510
Mailing Address - Fax:
Practice Address - Street 1:901 W VICTORIA ST STE F&G
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-5807
Practice Address - Country:US
Practice Address - Phone:310-669-9510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW132863104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker