Kasandra Jasmine Ibarra, CTRS
Counselor, Addiction (Substance Use Disorder) in Los Angeles, CA. Individual provider (NPI-1).
NPI number1710690748
StatusActive
Last updated in NPPESSep 24, 2024
Details
- NPI
- 1710690748
- Entity type
- Individual (NPI-1)
- Name
- Kasandra Jasmine Ibarra
- Credential
- CTRS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 4, 2023
- Certification date
- Sep 24, 2024
- Last updated
- Sep 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 18041 | CA | Yes |
| 225800000X | Recreation Therapist | – | CA |
Practice location
12021 Wilmington AveBldg. 18 Suite 300
Los Angeles, CA 90059
Phone 424-454-6041
Mailing address
12021 Wilmington AveBldg. 18 Suite 300
Los Angeles, CA 90059
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