Healthcare Provider Details

I. General information

NPI: 1639094139
Provider Name (Legal Business Name): MS. JOCELYN JIMENEZ VARGAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 NORTHSTEAD DR
SACRAMENTO CA
95833-1216
US

IV. Provider business mailing address

3201 NORTHSTEAD DR
SACRAMENTO CA
95833-1216
US

V. Phone/Fax

Practice location:
  • Phone: 916-566-2730
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number250140584
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: