Individual
BASILLE JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1411 W 190TH ST STE 110, GARDENA, CA 90248-4370
(310) 719-3908
Mailing address
1411 W 190TH ST STE 110, GARDENA, CA 90248-4370
(310) 719-3908
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/24/2023
Last updated
10/16/2025
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