Holly Ann Jimenez

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

9890 County Farm Rd Ste 3
Riverside, CA 92503-3678

Phone

(951) 509-2499

NPI assigned

Aug 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1780163469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22445 ALESSANDRO BLVD # 113-114",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538358",
            "telephone_number": "951-788-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9890 COUNTY FARM RD STE 3",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033678",
            "telephone_number": "951-509-2499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22445 Alessandro Blvd # 113-114",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925538358",
            "country_code": "US",
            "telephone_number": "951-788-8812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angeles Andrea Jimenez
• Ashley Anahi Jimenez
• Briahna Lenice Jimenez, LVN
• Cynthia Aurora Jimenez
• Evangelene Jimenez
• Janet Jimenez
• Jazmin Jimenez
• Jean Carlos Jimenez
• Kiromi Jimenez, M.S., BCBA
• Lauren Danielle Jimenez

• Peer Specialist in Riverside, CA
• Providers in Riverside, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.