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NPI Code Detail

MEDICARE: LUISA MARIA JIMENEZ

MEDICARE: LUISA MARIA JIMENEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker105650

General Provider Information

NPI Number : 1063041333
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUISA MARIA JIMENEZ
Provider Business Mailing Address
First Line : 3501 WILSON ROAD
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93304
Country : US
Telephone Number : 661-397-8775
Fax Number : 661-397-8286
Provider Business Practice Location Address
First Line : 5400 KEARNY MESA RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-1303
Country : US
Telephone Number : 619-717-2363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2020
Last Update Date : 05/15/2024

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Directions to “ LUISA MARIA JIMENEZ ” Practice Location

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