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NPI Code Detail

MEDICARE: CLARA L JIMENEZ LPC

MEDICARE: CLARA L JIMENEZ LPC
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
1101YM0800XMental Health CounselorLPC-20977AZ

General Provider Information

NPI Number : 1891400438
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARA L JIMENEZ LPC
Provider Business Mailing Address
First Line : 6751 N SUNSET BLVD STE 320
Second Line :
City : GLENDALE
State : AZ
Zip : 85305-3155
Country : US
Telephone Number : 602-677-6931
Fax Number :
Provider Business Practice Location Address
First Line : 6751 N SUNSET BLVD STE 320
Second Line :
City : GLENDALE
State : AZ
Zip : 85305-3155
Country : US
Telephone Number : 602-677-6931
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2023
Last Update Date : 06/13/2024

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Directions to “ CLARA L JIMENEZ LPC” Practice Location

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