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General NPI Number Information
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NPI Number | 1659965945
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Entity Type | Individual
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Provider Name | GENESIS ANAIR JIMENEZ
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Gender | Female
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Dates
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Enumeration Date | 02/26/2021
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | SPRING VALLEY 10411 MOTOR CITY DRIVE SUITE 500
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City | BETHESDA
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State | MD
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Zip | 20817-2081
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Country | US
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Telephone | 818-241-6780
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Fax |
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Provider Business Mailing Address
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Address Line | 1055 E COLORADO BLVD STE 560
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City | PASADENA
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State | CA
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Zip | 91106-2380
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Country | US
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Telephone | 818-341-6780
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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