Provider Demographics
NPI:1689170474
Name:HUMES, JASMINE MARIE (BCBA)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:MARIE
Last Name:HUMES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 E 90TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002-1614
Mailing Address - Country:US
Mailing Address - Phone:310-741-0026
Mailing Address - Fax:
Practice Address - Street 1:1957 ARCADIA CT
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-5415
Practice Address - Country:US
Practice Address - Phone:408-688-1373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-21-53097103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst