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Individual
ALFONSO JIMENEZ JR.
Active
Individual
ALFONSO JIMENEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101076
MEDI-CAL
CA
Enumeration date
02/20/2008
Last updated
02/20/2008
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