NPIMap

Individual provider Active NPI

Alfonso Jimenez Jr.

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1295904555
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
114 E Shaw Ave Ste 210
Fresno, CA 93710-7621
Phone
(559) 221-8100
NPI assigned
Feb 20, 2008
Last updated
Feb 20, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

114 E Shaw Ave Ste 210
Fresno, CA 93710-7621

Mailing address

370 Pierce Dr
Clovis, CA 93612-0742
Phone (951) 300-7361

Other identifiers 1

IdentifierTypeStateIssuer
101076OtherCAMEDI-CAL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eminence Healthcare Services, LLC Past Accepting new patients
Eminence Healthcare, Inc. Past Accepting new patients
Eminence Healthcare Services, LLC Past Accepting new patients
Eminence Healthcare Services, LLC Past Accepting new patients
Eminence Healthcare Services, LLC Past Accepting new patients
Eminence Healthcare Services, LLC Past Accepting new patients
Eminence Healthcare Services, LLC Past Accepting new patients
Eminence Healthcare Services, LLC Past Accepting new patients
Eminence Healthcare Services, LLC Past Accepting new patients
Eminence Healthcare Services, LLC Past Accepting new patients
Eminence Healthcare, Inc. Past Accepting new patients
Eminence Healthcare, Inc. Past Accepting new patients
Eminence Healthcare Services, LLC Past Accepting new patients
Eminence Healthcare, Inc. Past Accepting new patients

Organizations & group practices 14

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

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1295904555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 PIERCE DR",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120742",
            "telephone_number": "951-300-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E SHAW AVE STE 210",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107621",
            "telephone_number": "559-221-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ALFONSO",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "101076",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.