Individual
ALLEN JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
31764 CASINO DR STE 300, LAKE ELSINORE, CA 92530-2312
(951) 471-4645
Mailing address
31764 CASINO DR STE 300, LAKE ELSINORE, CA 92530-2312
(951) 471-4645
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/07/2022
Last updated
12/04/2023
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