Provider Demographics
NPI:1164227344
Name:JIMENEZ, FLOR ALEJANDRA
Entity type:Individual
Prefix:MS
First Name:FLOR
Middle Name:ALEJANDRA
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALEJANDRA
Other - Middle Name:
Other - Last Name:JIMENEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3639 E AVENUE R12
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-5786
Mailing Address - Country:US
Mailing Address - Phone:818-993-2295
Mailing Address - Fax:
Practice Address - Street 1:7313 WHITTIER AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1132
Practice Address - Country:US
Practice Address - Phone:424-442-9129
Practice Address - Fax:310-943-3821
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6776224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant