Provider Demographics
NPI:1295247898
Name:PIMENTEL, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:PIMENTEL
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 1:40081 SAN IGNACIO RD
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-9239
Mailing Address - Country:US
Mailing Address - Phone:619-343-0847
Mailing Address - Fax:
Practice Address - Street 1:40081 SAN IGNACIO RD
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-9239
Practice Address - Country:US
Practice Address - Phone:619-343-0847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-04
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151730106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist