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General NPI Number Information
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NPI Number | 1881837268
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Entity Type | Individual
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Provider Name | REYNALDO JOE JIMENEZ
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Gender | Male
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 303 W LINCOLN AVE STE 130
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City | ANAHEIM
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State | CA
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Zip | 92805-2993
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Country | US
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Telephone | 714-520-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 405 W 5TH ST STE 202A
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City | SANTA ANA
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State | CA
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Zip | 92701-4522
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Country | US
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Telephone | 949-621-9042
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 138647
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License Number State | CA
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