Individual provider Active NPI

Elizabeth Christine Jimenez, PA-C

  • Physician Assistant
  • Camarillo, CA
National Provider Identifier
1730482183
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
51547 Issued in CA
Practice address
2485 Ventura Blvd
Camarillo, CA 93010-6650
Phone
(805) 364-0889
Fax
(805) 200-4434
NPI assigned
Dec 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 51547 CA Primary

Addresses

Primary practice location

2485 Ventura Blvd
Camarillo, CA 93010-6650

Mailing address

1361 W 9TH Ave Apt 1000
Escondido, CA 92029-2215
Phone (508) 410-4720

Other practice location 1

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone (858) 859-1188

Other practice location 2

1361 W 9th Ave Apt 1000
Escondido, CA 92029-2215
Phone (508) 410-4720

Other identifiers 1

IdentifierTypeStateIssuer
D400090521OtherMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240726003294 CA Practitioner - Physician Assistant 5395920268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2518CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Guardiant Health CurrentSince Aug 17, 2025 Accepting new patients
Guardiant Health PC PastSince Aug 17, 2025 Accepting new patients

Locations

2485 Ventura Blvd
Camarillo, CA 93010
Phone (714) 453-7047

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1730482183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 W 9TH AVE APT 1000",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920292215",
            "telephone_number": "508-410-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 VENTURA BLVD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106650",
            "telephone_number": "805-364-0889",
            "fax_number": "805-200-4434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6195 Lusk Blvd Ste 250",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921213715",
            "country_code": "US",
            "telephone_number": "858-859-1188",
            "fax_number": "844-404-8924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1361 W 9th Ave Apt 1000",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920292215",
            "country_code": "US",
            "telephone_number": "508-410-4720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ELIZABETH",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-07",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "D400090521",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.