Provider Demographics
NPI:1932709003
Name:VEGA, JAZMIN (ASW)
Entity type:Individual
Prefix:
First Name:JAZMIN
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 LE FLORE DR
Mailing Address - Street 2:
Mailing Address - City:LA HABRA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:90631-8622
Mailing Address - Country:US
Mailing Address - Phone:323-517-8723
Mailing Address - Fax:
Practice Address - Street 1:1601 LE FLORE DR
Practice Address - Street 2:
Practice Address - City:LA HABRA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:90631-8622
Practice Address - Country:US
Practice Address - Phone:323-517-8723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2025-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119566101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health