Provider Demographics
NPI:1962548644
Name:JIMENEZ, BELEN MARIA (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:BELEN
Middle Name:MARIA
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 VIEWPARK CIR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136-2122
Mailing Address - Country:US
Mailing Address - Phone:408-674-2356
Mailing Address - Fax:
Practice Address - Street 1:280 HOSPITAL PKWY
Practice Address - Street 2:BLDG B
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1103
Practice Address - Country:US
Practice Address - Phone:408-363-4941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 13247235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist