Healthcare Provider Details

I. General information

NPI: 1073418042
Provider Name (Legal Business Name): EVANGELINE GALAURA JIMENEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22103 REDWOOD RD
CASTRO VALLEY CA
94546-7107
US

IV. Provider business mailing address

31770 ALVARADO BLVD APT 76
UNION CITY CA
94587-3961
US

V. Phone/Fax

Practice location:
  • Phone: 510-537-8848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number01320167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: