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NPI Code Detail

MEDICARE: DR. CHRISALBETH JIMENEZ GUILLERMO D.O.

MEDICARE: DR. CHRISALBETH JIMENEZ GUILLERMO D.O.
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
12084P0800XPsychiatry PhysicianOT016614PA
22084P0800XPsychiatry Physician20A25101CA

General Provider Information

NPI Number : 1356723910
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISALBETH JIMENEZ GUILLERMO D.O.
Provider Business Mailing Address
First Line : 823 GATEWAY CENTER WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4541
Country : US
Telephone Number : 619-515-2300
Fax Number :
Provider Business Practice Location Address
First Line : 5472 EL CAJON BLVD STE 101
Second Line :
City : SAN DIEGO
State : CA
Zip : 92115-3651
Country : US
Telephone Number : 619-269-0836
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2015
Last Update Date : 05/27/2026

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