Provider Demographics
NPI:1295357705
Name:JIMENEZ GOVEA, ERIK
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:JIMENEZ GOVEA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 UNIVERSITY DR APT 17D
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3475
Mailing Address - Country:US
Mailing Address - Phone:919-849-5559
Mailing Address - Fax:
Practice Address - Street 1:4506 S MIAMI BLVD STE 100
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8001
Practice Address - Country:US
Practice Address - Phone:984-849-5559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1-25-84715103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst