MEDICARE: GILBERT JAIMES

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
1	1041C0700X	Clinical Social Worker	ASW126407	CA

General Provider Information

NPI Number	:	1447895610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILBERT JAIMES

Provider Business Mailing Address
First Line	:	1092 NEW YORK DR
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-3118
Country	:	US
Telephone Number	:	323-926-0774
Fax Number	:

Provider Business Practice Location Address
First Line	:	1092 NEW YORK DR
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-3118
Country	:	US
Telephone Number	:	213-626-6411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2019
Last Update Date	:	10/23/2024

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Directions to “ GILBERT JAIMES ” Practice Location

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