Individual
ANDREW JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 525-7411
Mailing address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 525-7411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17260
CA
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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