Jimmy Don Hargrove, MFTI
Individual provider Active NPI Marriage & Family Therapist · Thousand Palms, CA
NPI 1053673301 · NPPES record last updated Jun 12, 2012
Key facts
- NPI
- 1053673301
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 66850 (CA)
- Practice address
- 72710 E Lynn St
Thousand Palms, CA 92276-3312 - Phone
- (760) 343-3211
- NPI assigned
- Jun 12, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66850 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Operation Safe House, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 66850 | CA | Yes |
Addresses
Primary practice location
72710 E Lynn St
Thousand Palms, CA 92276-3312
Mailing address
34538 Double Diamond Dr
Thousand Palms, CA 92276-4107
Phone (760) 702-1715
Other providers in Thousand Palms, CA
- De Luz Home Care LLC
- De Luz Home Care LLC
- Pan Elliott
- Empowerment Home Care LLC
- Alma Nicole Garcia Duarte
- Ima Jean Heron
- Denisse Jara
- Veronica Lievanos
- Lifecare Solutions Inc
- Jorge Lopez Ruiz
All providers in Thousand Palms, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.