Elizabeth Jimenez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW100356 Issued in CA

Practice address

505 N Euclid St Ste 300
Anaheim, CA 92801-5514

Phone

(714) 871-5646

NPI assigned

Sep 6, 2017

Reactivated

May 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Hemet, CA
  • NPI 1013433465
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• All for Kids Organization

  • Community/Behavioral Health Agency
  • Palmdale, CA
  • NPI 1609902436
  NPD (past)
• Western Youth Services

  • Adolescent and Children Mental Health Clinic/Center
  • Anaheim, CA
  • NPI 1770617987
  NPD (past)

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1467970889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N EUCLID ST STE 300",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015514",
            "telephone_number": "714-871-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N EUCLID ST STE 300",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015514",
            "telephone_number": "714-871-5646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1529 E Palmdale Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935502029",
            "country_code": "US",
            "telephone_number": "661-272-9996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1529 E Palmdale Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935502029",
            "country_code": "US",
            "telephone_number": "661-272-9996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2022-02-11",
        "certification_date": "2021-03-22",
        "deactivation_date": "2019-04-23",
        "reactivation_date": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW100356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Guadalupe Jimenez-Howard, MD
• Francelly J Jimenez-Palacios
• Alicia Jimenez
• Angelique Jimenez
• Brenda Jimenez
• Iviana D Jimenez, LCSW
• Jazmin Jimenez
• Kassandra Jimenez
• Leana Jimenez
• Maria Christine Jimenez, M.A., BCBA

• Clinical Social Worker in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.