Active NPI
Eric Jimenez
- Behavior Technician
- Westminster, CA
National Provider Identifier
1154913499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- F2677469
- Practice address
- 7731 Trask Ave Apt 102
Westminster, CA 92683-2301 - Phone
- (714) 818-8561
- NPI assigned
- Feb 8, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | F2677469 | CA | Primary |
Addresses
Primary practice location
7731 Trask Ave Apt 102
Westminster, CA 92683-2301
Mailing address
7731 Trask Ave Apt 102
Westminster, CA 92683-2301
Phone (714) 818-8561
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 90879666E37233 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F2677469 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612742400000",
"number": "1154913499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7731 TRASK AVE APT 102",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926832301",
"telephone_number": "714-818-8561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7731 TRASK AVE APT 102",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926832301",
"telephone_number": "714-818-8561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "ERIC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-08",
"last_updated": "2021-02-08",
"certification_date": "2021-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "F2677469",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "90879666E37233",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westminster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.