Most Relevant Information
Provider Data
| NPI Number: | 1003448473 |
| Provider Name: | ANGELICA JIMENEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/04/2020 |
| Last Updated: | 07/27/2020 |
Provider Practice Location
8755 AERO DR STE 230
SAN DIEGO
CA
921231750
Practice Location Phone/Fax
| Phone: | 8582562180 |
| Fax: |
Provider Mailing Location
8755 AERO DR STE 230
SAN DIEGO
CA
921231750
Provider Mailing Phone/Fax
| Phone: | 8582562180 |
| Fax: |