Active NPI
Astrid Jimenez
- Behavior Technician
- Rancho Cucamonga, CA
National Provider Identifier
1992569693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 11799 Sebastian Way Ste 103
Rancho Cucamonga, CA 91730-0708 - Phone
- (909) 942-1630
- NPI assigned
- Feb 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | CA | Primary |
Addresses
Primary practice location
11799 Sebastian Way Ste 103
Rancho Cucamonga, CA 91730-0708
Mailing address
1325 N Mills Ave
Pomona, CA 91767-4568
Phone (909) 541-4324
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1992569693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 N MILLS AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917674568",
"telephone_number": "909-541-4324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11799 SEBASTIAN WAY STE 103",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917300708",
"telephone_number": "909-942-1630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "ASTRID",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-13",
"last_updated": "2024-02-13",
"certification_date": "2024-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.