Active NPI
Stephanie Jimenez
- Addiction (Substance Use Disorder) Counselor
- Los Angeles, CA
National Provider Identifier
1174371645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 4445 Burns Ave
Los Angeles, CA 90029-2702 - Phone
- (323) 222-1400
- NPI assigned
- May 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 16238 | CA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
4445 Burns Ave
Los Angeles, CA 90029-2702
Mailing address
4445 Burns Ave
Los Angeles, CA 90029-2702
Phone (323) 222-1400
Other practice location 1
11027 Burbank Blvd
North Hollywood, CA 91601-2431
Phone (818) 985-8323
Other practice location 2
3619 N Mission Rd
Lincoln Heights, CA 90031-3136
Phone (213) 721-0010
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 |
|---|---|---|---|
| 16238 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745971200000",
"number": "1174371645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4445 BURNS AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900292702",
"telephone_number": "323-222-1400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4445 BURNS AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900292702",
"telephone_number": "323-222-1400"
}
],
"practiceLocations": [
{
"address_1": "11027 Burbank Blvd",
"address_purpose": "LOCATION",
"city": "North Hollywood",
"state": "CA",
"postal_code": "916012431",
"country_code": "US",
"telephone_number": "818-985-8323",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3619 N Mission Rd",
"address_purpose": "LOCATION",
"city": "Lincoln Heights",
"state": "CA",
"postal_code": "900313136",
"country_code": "US",
"telephone_number": "213-721-0010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JIMENEZ",
"first_name": "STEPHANIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-09",
"last_updated": "2025-04-30",
"certification_date": "2025-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "16238",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.