Individual
ALFONSO JIMENEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
114 E SHAW AVE STE 210, FRESNO, CA 93710-7621
(559) 221-8100
Mailing address
370 PIERCE DR, CLOVIS, CA 93612-0742
(951) 300-7361
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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