Glenda Fe Jimenez, RN

Individual provider Active NPI Registered Nurse · McClellan, CA

NPI 1225314503 · NPPES record last updated Oct 31, 2011

Key facts

NPI
1225314503
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
653492 (CA)
Practice address
5342 Dudley Blvd
McClellan, CA 95652-1012
Phone
(916) 561-7520
Fax
(916) 561-7529
NPI assigned
Oct 31, 2011
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
653492CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 653492 CA Yes

Addresses

Primary practice location

5342 Dudley Blvd
McClellan, CA 95652-1012

Mailing address

5342 Dudley Blvd
McClellan, CA 95652-1012
Phone (916) 561-7520

Other providers in McClellan, CA

All providers in McClellan, CA · Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.