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General NPI Number Information
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NPI Number | 1356272371
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Entity Type | Individual
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Provider Name | KENDAL KRISTINE JIMENEZ
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Gender | Female
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Dates
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Enumeration Date | 05/27/2026
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Last Update Date | 05/27/2026
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Provider Practice Location Address
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Address Line | 11940 CAROLINA PLACE PKWY STE 200
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City | PINEVILLE
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State | NC
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Zip | 28134-7471
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Country | US
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Telephone | 704-541-9080
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Fax |
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Provider Business Mailing Address
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Address Line | 4109 SPRING ST
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City | MATTHEWS
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State | NC
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Zip | 28105-7220
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Country | US
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Telephone | 530-570-5678
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A22947
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License Number State | NC
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