Provider Demographics
NPI:1710700182
Name:JIMENEZ MONTANO, ARELIE
Entity type:Individual
Prefix:
First Name:ARELIE
Middle Name:
Last Name:JIMENEZ MONTANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 S NORMANDIE AVE APT 304
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-2220
Mailing Address - Country:US
Mailing Address - Phone:213-820-8443
Mailing Address - Fax:
Practice Address - Street 1:720 S NORMANDIE AVE APT 304
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-2220
Practice Address - Country:US
Practice Address - Phone:213-820-8443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst