Ashley M Jimenez

Individual provider Active NPI Behavior Technician · Alta Loma, CA

NPI 1407515364 · NPPES record last updated Dec 21, 2022

Key facts

NPI
1407515364
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-22-246655 (CA)
Practice address
9250 Highland Ave
Alta Loma, CA 91701-4127
Phone
(909) 921-9873
NPI assigned
Dec 8, 2021
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

State licenses

LicenseStateTypeSpecialty
RBT-22-246655CAMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-22-246655 CA Yes

Addresses

Primary practice location

9250 Highland Ave
Alta Loma, CA 91701-4127

Mailing address

16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Phone (855) 223-7123

Other providers in Alta Loma, CA

All providers in Alta Loma, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.