Provider Demographics
NPI:1043700362
Name:FRIAS, JAZMIN MARIE-AGUILAR
Entity type:Individual
Prefix:
First Name:JAZMIN
Middle Name:MARIE-AGUILAR
Last Name:FRIAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JAZMIN
Other - Middle Name:MARIE
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5409 RABBIT HILL CT
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CA
Mailing Address - Zip Code:95368-9004
Mailing Address - Country:US
Mailing Address - Phone:510-931-9099
Mailing Address - Fax:510-931-9099
Practice Address - Street 1:2515 YOUNGSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380
Practice Address - Country:US
Practice Address - Phone:510-931-9099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician