Healthcare Provider Details

I. General information

NPI: 1700410883
Provider Name (Legal Business Name): EDITH JAIMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13525 CIELO AZUL WAY
DESERT HOT SPRINGS CA
92240-6235
US

IV. Provider business mailing address

13525 CIELO AZUL WAY
DESERT HOT SPRINGS CA
92240-6235
US

V. Phone/Fax

Practice location:
  • Phone: 760-329-4673
  • Fax: 760-329-7311
Mailing address:
  • Phone: 760-329-4673
  • Fax: 760-329-7311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: