Edna Jimenez, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY14574 Issued in CA

Practice address

100 E Thousand Oaks Blvd Ste 217
Thousand Oaks, CA 91360-8177

Phone

(818) 371-8818

Fax

(805) 778-1061

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Persona Neuro Behavior Group Inc.

  • Clinical Neuropsychologist
  • South Pasadena, CA
  • NPI 1881798171
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1992805048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E THOUSAND OAKS BLVD STE 217",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608177",
            "telephone_number": "818-371-8818",
            "fax_number": "805-778-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E THOUSAND OAKS BLVD STE 217",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608177",
            "telephone_number": "818-371-8818",
            "fax_number": "805-778-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "EDNA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yoonki Jeong, AC
• Jerry H. Kaye, M.D., Inc.
• Jessica Marie Adkins MD PC
• Keyi Jiang, MD
• Jigar Ghelani MD a Professional Corporation
• Roberto Jimenez
• Cassandra Llaguno Jingco
• Bachir Jirari, M.D.
• Kristen Renee Jirele, MS PT
• Arpi Marie Jivalagian, MD

• Clinical Psychologist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.