Ifeanyi Jimmy

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

132326 Issued in CA

Practice address

302 Cherry LN
Manteca, CA 95337-4311

Phone

(530) 893-0758

NPI assigned

Sep 23, 2020

Last updated

Jun 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

Marriage and Family Therapist

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• San Joaquin Behavioral Health Services

  dba San Joaquin County Behavioral Health Services

  • Community/Behavioral Health Agency
  • Stockton, CA
  • NPI 1215028931
  Medicare reassignment

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1679189724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 CHERRY LN",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374311",
            "telephone_number": "530-893-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CHERRY LN",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374311",
            "telephone_number": "530-893-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMMY",
        "first_name": "IFEANYI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-23",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "132326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Elise Jenkins, DPT
• Manop Edward Jennings, B.A.
• Heesoo Jeong
• Jennifer Jimenez-Cuevas
• Melanie Dawn Jimenez, MSW
• Joe Ngoc Bui DO Inc
• Benjamin Joe, PHARM.D.
• Naveet Johal
• Harpreet Kaur Johl
• John C. Trueb, DDS

• Marriage & Family Therapist in Manteca, CA
• Providers in Manteca, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.