MEDICARE: MR. AARON JOSEPH JIMENEZ M.A.

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACD.0000539	CO

General Provider Information

NPI Number	:	1457795833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AARON JOSEPH JIMENEZ M.A.

Provider Business Mailing Address
First Line	:	478 E SCENIC DR
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81507-1588
Country	:	US
Telephone Number	:	970-589-1649
Fax Number	:

Provider Business Practice Location Address
First Line	:	2956 NORTH AVE STE 6
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81504-3919
Country	:	US
Telephone Number	:	970-589-1649
Fax Number	:	970-985-8036

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

Provider Enumeration Date	:	04/29/2013
Last Update Date	:	03/03/2021

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