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NPI Code Detail

MEDICARE: JASMELY JIMENEZ

MEDICARE: JASMELY JIMENEZ
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1740163245
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMELY JIMENEZ
Provider Business Mailing Address
First Line : 2550 N HOLLYWOOD WAY STE 301
Second Line :
City : BURBANK
State : CA
Zip : 91505-5025
Country : US
Telephone Number : 866-727-8274
Fax Number :
Provider Business Practice Location Address
First Line : 360 MERRIMACK ST STE 132
Second Line :
City : LAWRENCE
State : MA
Zip : 01843-2162
Country : US
Telephone Number : 866-727-8274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2025
Last Update Date : 07/30/2025

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Directions to “ JASMELY JIMENEZ ” Practice Location

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