MEDICARE: LISA JIMENEZ REHABILITATION SPECI

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	171M00000X	Case Manager/Care Coordinator
3	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1558653972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA JIMENEZ REHABILITATION SPECI

Provider Business Mailing Address
First Line	:	222 CARMEN LN STE 106
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93458-7700
Country	:	US
Telephone Number	:	58-450-3330
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 CARMEN LN STE 106
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93458-7700
Country	:	US
Telephone Number	:	805-450-3330
Fax Number	:	805-803-8647

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

Provider Enumeration Date	:	05/03/2011
Last Update Date	:	06/11/2025

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