| Doctor Name: | VANESSA JIMENEZ |
| NPI Number: | 1023320454 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BACHELORS |
| License Number: | |
| Business Practice Address: | 1350 3rd St La Verne, CA - 917505201 |
| Business Phone Number: | 9095965921 |
| Business Fax Number: | 9095963954 |
| Mailing Address: | 1350 3rd St, LA VERNE |
| State: | CA |
| Postal Code: | 917505201 |
| Phone Number: | 9095965921 |
| Fax Number: | 9095963954 |
| NPI Enumeration Date: | 07/14/2010 |
| NPI Last Update Date: | 07/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |