Individual
JULISSA JAIMES-GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1211 CENTER COURT DR, COVINA, CA 91724-3613
(626) 859-2089
(626) 859-6537
Mailing address
1211 CENTER COURT DR, COVINA, CA 91724-3613
(626) 859-2089
(626) 859-6537
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
CA
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
09/13/2022
Last updated
06/05/2025
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