Individual
TINA JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1720 E 120TH ST, LOS ANGELES, CA 90059-3052
(310) 668-4495
Mailing address
1720 E 120TH ST, LOS ANGELES, CA 90059-3052
(310) 668-4495
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY34781
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/16/2019
Last updated
03/05/2025
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