Doctor Name: | MARIO R JIMINEZ |
NPI Number: | 1528181070 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 507 F St Eureka, CA - 955011009 |
Business Phone Number: | 7074415510 |
Business Fax Number: | 7074415581 |
Mailing Address: | 30 W Simpson St, Apt A EUREKA |
State: | CA |
Postal Code: | 955015333 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/09/2007 |
NPI Last Update Date: | 05/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |