Individual provider Active NPI

Rayeann Jimenez

  • Adult Companion
  • Santa Cruz, CA
National Provider Identifier
1487829263
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
License
C056680518 Issued in CA
Practice address
1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone
(831) 454-4170
Fax
(831) 454-4663
NPI assigned
Apr 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C056680518 CA
Adult Companion 372600000X C056680518 CA Primary

Addresses

Primary practice location

1400 Emeline Ave
Santa Cruz, CA 95060-1976

Mailing address

1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone (831) 454-4170

Other identifiers 2

IdentifierTypeStateIssuer
FHC70042FOtherCASANTA CRUZ COUNTY MEDI-CAL PTAN#
FHC70044FOtherCASANTA CRUZ COUNTY MEDI-CAL PTAN#

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

State licenses

LicenseStateTypeSpecialty
C056680518CAMDAdult Companion

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1487829263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601976",
            "telephone_number": "831-454-4170",
            "fax_number": "831-454-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601976",
            "telephone_number": "831-454-4170",
            "fax_number": "831-454-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "RAYEANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C056680518",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "CA",
            "license": "C056680518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDI-CAL PTAN#",
            "identifier": "FHC70042F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDI-CAL PTAN#",
            "identifier": "FHC70044F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.