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Search › California › 101YA0400X

Juan Jimenez

NPI 1548732191 · on the registry since 2018 · sole proprietor

Practice

Address
11600 Eldridge Ave
Lake View Terrace, CA 91342
Phone
(661) 406-8764
Organisation at this address
Phoenix House Foundation
Phoenix Houses Of Los Angeles, Inc.
Phoenix Houses Of Los Angeles, Inc.
Phoenix House California - Lake View Terrace
Inferred from a shared address, not stated in the registry.
Clinicians at this address
161

Registry record

Primary taxonomy
101YA0400X
101YA0400X
Licence states on file
NULL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-12-20
Status
Not present in the most recent federal file

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California