Individual provider Active NPI

Jimmy Maldonado

  • Marriage & Family Therapist
  • Clovis, CA
National Provider Identifier
1093504656
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
146193 Issued in CA
Practice address
2121 Herndon Ave Ste 102
Clovis, CA 93611-6302
Phone
(562) 335-6484
NPI assigned
May 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 146193 CA Primary

Addresses

Primary practice location

2121 Herndon Ave Ste 102
Clovis, CA 93611-6302

Mailing address

2121 Herndon Ave Ste 102
Clovis, CA 93611-6302
Phone (562) 335-6484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1093504656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 HERNDON AVE STE 102",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116302",
            "telephone_number": "562-335-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 HERNDON AVE STE 102",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116302",
            "telephone_number": "562-335-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "JIMMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "146193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.