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NPI Code Detail

MEDICARE: YARELI JIMENEZ

MEDICARE: YARELI 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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1619444759
Entity Type Code : Individual
Provider Name (Legal Business Name) : YARELI JIMENEZ
Provider Business Mailing Address
First Line : 3650 MT DIABLO BLVD STE 107
Second Line :
City : LAFAYETTE
State : CA
Zip : 94549-3780
Country : US
Telephone Number : 510-665-9700
Fax Number :
Provider Business Practice Location Address
First Line : 1651 RESPONSE RD STE 200
Second Line :
City : SACRAMENTO
State : CA
Zip : 95815-5255
Country : US
Telephone Number : 916-518-3187
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2018
Last Update Date : 03/01/2024

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Directions to “ YARELI JIMENEZ ” Practice Location

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