Active NPI
Jose Alfredo Jimenez, AA
- Community Health Worker
- Los Angeles, CA
National Provider Identifier
1245882190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 5000 W Sunset Blvd
Los Angeles, CA 90027-5861 - Phone
- (323) 439-8315
- Fax
- (909) 865-9281
- NPI assigned
- Jul 11, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
5000 W Sunset Blvd
Los Angeles, CA 90027-5861
Mailing address
2008 N Garey Ave
Pomona, CA 91767-2722
Phone (909) 623-6131
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
- Credentials
- Associate of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-City Mental Health Authority | Current | Accepting new patients | |
| Tri-City Mental Health Center | Past | Accepting new patients |
Locations
2008 N Garey Ave
Pomona, CA 91767
Phone (909) 242-7640
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Pomona, CA
- NPI 1346304920
-
- Case Management Agency
- Pomona, CA
- NPI 1255651501
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708560000000",
"number": "1245882190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2008 N GAREY AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917672722",
"telephone_number": "909-623-6131",
"fax_number": "909-865-9281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 W SUNSET BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275861",
"telephone_number": "323-439-8315",
"fax_number": "909-865-9281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "JOSE",
"middle_name": "ALFREDO",
"credential": "AA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-11",
"last_updated": "2024-02-22",
"certification_date": "2024-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"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 Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.