Provider Demographics
NPI:1902780760
Name:CEDILLO, JASSMIN ADELY (MS)
Entity type:Individual
Prefix:MRS
First Name:JASSMIN
Middle Name:ADELY
Last Name:CEDILLO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:JASSMIN
Other - Middle Name:ADELY
Other - Last Name:ROJAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:8887 PALMETTO AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-4939
Mailing Address - Country:US
Mailing Address - Phone:909-676-1257
Mailing Address - Fax:
Practice Address - Street 1:8887 PALMETTO AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-4939
Practice Address - Country:US
Practice Address - Phone:951-232-2503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care