Provider Demographics
NPI:1083847057
Name:SMITH JIMENEZ, ERICA M (BA, MA)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:M
Last Name:SMITH JIMENEZ
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Gender:F
Credentials:BA, MA
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Other - Credentials:
Mailing Address - Street 1:4917 MOUNTAIN BLVD
Mailing Address - Street 2:COMMUNITY DAY SCHOOL
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-3014
Mailing Address - Country:US
Mailing Address - Phone:510-879-8450
Mailing Address - Fax:
Practice Address - Street 1:15942 FOOTHILL BLVD
Practice Address - Street 2:SENECA HR
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2102
Practice Address - Country:US
Practice Address - Phone:510-317-1437
Practice Address - Fax:206-302-2210
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2013-01-24
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor