Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1326712829 |
---|---|
Provider Name | Ana Lidia Jimenez Colin |
First Address | Van Nuys, CA 91406-1219 |
Second Address | Van Nuys, CA 91406-1219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2021 |
Last Update Date | 06/08/2021 |