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NPI Code Detail

MEDICARE: JOSEPH GIMENEZ

MEDICARE: JOSEPH GIMENEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1396401469
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH GIMENEZ
Provider Business Mailing Address
First Line : 5861 CHERRY AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90805-4405
Country : US
Telephone Number : 562-676-4259
Fax Number :
Provider Business Practice Location Address
First Line : 5861 CHERRY AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90805-4405
Country : US
Telephone Number : 562-676-4259
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2021
Last Update Date : 11/12/2021

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Directions to “ JOSEPH GIMENEZ ” Practice Location

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