Most Relevant Information
Provider Data
| NPI Number: | 1003693532 |
| Provider Name: | THEODORE JIMENEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/08/2023 |
| Last Updated: | 09/08/2023 |
Provider Practice Location
1810 THRELKEL ST
RENO
NV
895123713
Practice Location Phone/Fax
| Phone: | 7753258297 |
| Fax: |
Provider Mailing Location
11620 CLAIM STAKE DR
RENO
NV
895067529
Provider Mailing Phone/Fax
| Phone: | 7753406326 |
| Fax: | 7755252426 |