Healthcare Provider Details

I. General information

NPI: 1588513402
Provider Name (Legal Business Name): DENISSE PAULINA JIMENEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SPECTRUM CENTER DR
IRVINE CA
92618-4925
US

IV. Provider business mailing address

4463 OHIO ST APT 5
SAN DIEGO CA
92116-4396
US

V. Phone/Fax

Practice location:
  • Phone: 619-887-9441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: