Jimenez, Juan Antonio

Jimenez, Juan Antonio is an sole proprietor health care provider with primary practice located at 11600 Eldridge Ave , Lake View Terrace CA 91342-6506. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Jimenez, Juan Antonio can be contacted via phone (661) 406-8764.

Contact Information

Primary practice address
11600 Eldridge Ave Lake View Terrace CA 91342-6506
Phone: (661) 406-8764
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1548732191
LBN Legal business name Jimenez, Juan Antonio
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 20th, 2018
Last updated Dec 20th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548732191 NPPES
California MEDICAID 101YA0400X

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