Provider Demographics
NPI:1740175504
Name:FOUCHA, JASZMINE
Entity type:Individual
Prefix:
First Name:JASZMINE
Middle Name:
Last Name:FOUCHA
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 1:5083 RADCLIFF ST
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-5547
Mailing Address - Country:US
Mailing Address - Phone:504-372-7839
Mailing Address - Fax:
Practice Address - Street 1:5083 RADCLIFF ST
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-5547
Practice Address - Country:US
Practice Address - Phone:504-372-7839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA106E00000X103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst