Provider Demographics
NPI:1316074214
Name:JIMENEZ, DOROTHY C (CASLL)
Entity type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:C
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:CASLL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-6226
Mailing Address - Country:US
Mailing Address - Phone:209-381-6850
Mailing Address - Fax:209-385-3174
Practice Address - Street 1:2130 COOPER AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-4304
Practice Address - Country:US
Practice Address - Phone:209-381-6850
Practice Address - Fax:209-385-3174
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor