Healthcare Provider Details

I. General information

NPI: 1598691115
Provider Name (Legal Business Name): YESENIA JIMENEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9514 N SUNSET SKY WAY
TUCSON AZ
85742-8398
US

IV. Provider business mailing address

9514 N SUNSET SKY WAY
ORO VALLEY AZ
85742-8398
US

V. Phone/Fax

Practice location:
  • Phone: 520-904-6521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026021461
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: