Individual provider Active NPI

Erika K. Johnson-Jimenez, PH.D.

  • Clinical Psychologist
  • Albuquerque, NM
National Provider Identifier
1548472806
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0952 Issued in NM
Practice address
13170 Central Ave SE
Suite B420
Albuquerque, NM 87123
Phone
(505) 385-0161
Fax
(505) 544-4648
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0952 NM Primary

Addresses

Primary practice location

13170 Central Ave SE
Suite B420
Albuquerque, NM 87123

Mailing address

13170 Central Ave SE
Suite B420
Albuquerque, NM 87123
Phone (505) 385-0161

Other identifiers 1

IdentifierTypeStateIssuer
31731783MedicaidNM

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)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1548472806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13170 CENTRAL AVE SE",
            "address_2": "SUITE B420",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87123",
            "telephone_number": "505-385-0161",
            "fax_number": "505-544-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13170 CENTRAL AVE SE",
            "address_2": "SUITE B420",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87123",
            "telephone_number": "505-385-0161",
            "fax_number": "505-544-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-JIMENEZ",
        "first_name": "ERIKA",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "0952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31731783",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.