Matthew Cesar Jimenez
Individual provider Active NPI Behavior Technician · Riverside, Ca, CA
NPI 1235700121 · NPPES record last updated Jul 2, 2021
Key facts
- NPI
- 1235700121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 2155 Chicago Avenue
Suite 203
Riverside, Ca, CA 92507 - Phone
- (951) 357-6926
- Fax
- (855) 568-2494
- NPI assigned
- Jul 2, 2021
- Sex
- Male
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
2155 Chicago Avenue
Suite 203
Riverside, Ca, CA 92507
Mailing address
18726 S. Western Avenue
Suite 408
Gardena, CA 90248
Phone (310) 856-0800
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.