Doctor Name: | MISS MARIA ASTRID KIM JIMENEZ GRACE |
NPI Number: | 1710371992 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PTA |
License Number: | AT9671 |
Business Practice Address: | 330 Golden Shr Suite 250 Long Beach, CA - 908024246 |
Business Phone Number: | 5622567550 |
Business Fax Number: | 8009855002 |
Mailing Address: | 8091 Constantine Dr Apt 4, HUNTINGTON BEACH |
State: | CA |
Postal Code: | 926461726 |
Phone Number: | 7144834970 |
Fax Number: | |
NPI Enumeration Date: | 03/25/2015 |
NPI Last Update Date: | 03/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171W00000X |
License Number: | AT9671 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |