Maryandrea Jimenez, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

697609 Issued in CA

Practice address

559 E Bardsley Ave
Tulare, CA 93274-5400

Phone

(559) 687-0929

NPI assigned

Apr 24, 2022

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

Other names 1

• Maryandrea Maldonado Former name

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.

• Kings View

  • Community/Behavioral Health Agency
  • Tulare, CA
  • NPI 1679797575
  NPD (past)

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

{
    "created_epoch": "1650758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1740924935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 E BARDSLEY AVE",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932745400",
            "telephone_number": "559-688-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 E BARDSLEY AVE",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932745400",
            "telephone_number": "559-687-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "MARYANDREA",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-24",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "697609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYANDREA",
            "last_name": "MALDONADO",
            "credential": "LVN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jasjeet S Malli DDS Inc
• Zoey Jauregui
• Cecilia Deliarose Jimenez
• Dora E Jimenez, LVN
• Lizette Jimenez
• Serina Jimenez
• Yuliana Jimenez
• Emily Marie Jimmeye
• Jocelyn P Reyes DMD Inc
• Gurleen Johal

• Licensed Vocational Nurse in Tulare, CA
• Providers in Tulare, CA by specialty
• Licensed Vocational Nurse in California

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