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NPI Code Detail

MEDICARE: ANDREA JANELLE JIMENEZ

MEDICARE:   ANDREA JANELLE 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
1225100000XPhysical Therapist309177CA

General Provider Information

NPI Number : 1427908458
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA JANELLE JIMENEZ
Provider Business Mailing Address
First Line : 68 TRANQUILO LN
Second Line :
City : CHULA VISTA
State : CA
Zip : 91911-3555
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 585 SATURN BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92154-4721
Country : US
Telephone Number : 619-591-1190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2026
Last Update Date : 01/29/2026

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Directions to “ ANDREA JANELLE JIMENEZ ” Practice Location

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