Healthcare Provider Details

I. General information

NPI: 1104329002
Provider Name (Legal Business Name): JENNIFER AIDEE LIMON-ARREDONDO AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2018
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44199 MONROE ST
INDIO CA
92201-3096
US

IV. Provider business mailing address

47825 OASIS ST
INDIO CA
92201-6950
US

V. Phone/Fax

Practice location:
  • Phone: 760-863-8328
  • Fax:
Mailing address:
  • Phone: 760-863-8441
  • Fax: 760-863-8587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number129416
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number150696
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: