Healthcare Provider Details

I. General information

NPI: 1134029986
Provider Name (Legal Business Name): HELORADANA JIMENEZ PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31749 TEMECULA PKWY
TEMECULA CA
92592-5869
US

IV. Provider business mailing address

42211 STONEWOOD RD APT 133
TEMECULA CA
92591-3877
US

V. Phone/Fax

Practice location:
  • Phone: 951-303-2363
  • Fax:
Mailing address:
  • Phone: 951-760-2898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number55318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: