Rafael Jimenez Jr.

Key facts

NPI

1225737166

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

Practice address

10535 Road 35
Madera, CA 93636-8487

Phone

(559) 437-1144

NPI assigned

Feb 28, 2023

Sex

Male

Sole proprietor

Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valley Teen Ranch Adolescent and Children Mental Health Clinic/Center · Madera, CA · NPI 1295191260
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 28, 2023.

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1225737166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 W SHAW LN STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 ROAD 35",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368487",
            "telephone_number": "559-437-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "RAFAEL",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

• Alma A Jimenez, LVN
• Kelli Jimenez, CAADE
• Laura Jimenez
• Liliana Nichols Jimenez
• Niobe Jimenez
• Rebecca Ann Jimenez
• Liann Hoang Jimmons, MS, LCGC
• Laide Adele Ajike Jinadu, M.D.
• John P S Janda MD, Inc.
• John R. Wiens DDS, Inc.

All providers in Madera, CA · Mental Health Counselor in California