Gonzalo Jimenez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

01542 Issued in TX

Practice address

1901 S 24TH Ave
Edinburg, TX 78539-6533

Phone

(956) 289-7000

Fax

(956) 289-7257

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Deer Oaks Geriatric Services P C

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1134169287
  NPD (past)
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1720184708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S 24TH AVE",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785396533",
            "telephone_number": "956-289-7000",
            "fax_number": "956-289-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S 24TH AVE",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785396533",
            "telephone_number": "956-289-7000",
            "fax_number": "956-289-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "GONZALO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "01542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00R945",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138708611",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138708613",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammed Waleed Jeraq, M.D
• Jhonsdtc Inc
• Jimenez Pediatrics
• Jimenez Pediatrics
• David Lee Jimenez, MD
• Michelle Ann Ibarra Jimenez, M.D.
• Betty John
• Greeshma Elizabeth John
• Cherie J Johnson, MD
• Rose J Johnson

• Clinical Social Worker in Edinburg, TX
• Providers in Edinburg, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.