Healthcare Provider Details

I. General information

NPI: 1679426167
Provider Name (Legal Business Name): JIMENA GALANIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JIMENA ZARATE BURUNAT

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 LA SELVA ST
SAN MATEO CA
94403-2148
US

IV. Provider business mailing address

6003 BOUNTY ST
SAN DIEGO CA
92120-2922
US

V. Phone/Fax

Practice location:
  • Phone: 650-223-5605
  • Fax:
Mailing address:
  • Phone: 347-677-4694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT161663
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: