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General NPI Number Information
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NPI Number | 1073844890
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Entity Type | Individual
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Provider Name | KAREN OWEN JIMENEZ
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Gender | Female
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Dates
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Enumeration Date | 01/18/2010
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 623 GEORGES RD
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08902-3386
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Country | US
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Telephone | 973-234-4318
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Fax |
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Provider Business Mailing Address
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Address Line | 623 GEORGES ROAD
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35SI00564700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3613
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License Number State | PR
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