Elizabeth Marie Jimenez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 29418 Issued in CA

Practice address

1800 Gravenstein Hwy N
Sebastopol, CA 95472-2607

Phone

(707) 634-9061

NPI assigned

Mar 25, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• TLC Child & Family Services

  • Adolescent and Children Mental Health Clinic/Center
  • Sebastopol, CA
  • NPI 1073131942
  NPD (past)

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1487978011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GRAVENSTEIN HWY N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722607",
            "telephone_number": "707-634-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 GRAVENSTEIN HWY N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722607",
            "telephone_number": "707-634-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 29418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Marie Jacobs, M.S.P.T.
• Jaiyen Spa
• James F Yusuf Q Erskine DO Inc
• Eun Sub Jang, D. D. S.
• Barbara Anne Jason, PHARMACY TECHNICIAN
• Angelica Roseria Jochim, MFT
• Jill Johnson, RD
• Judith Blackbird Joinville, LMFT
• Sarah Elizabeth Jolley, MFT
• Elizabeth Jones

• Clinical Social Worker in Sebastopol, CA
• Providers in Sebastopol, 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 Mar 19, 2019; 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.