Provider Demographics
NPI:1407268238
Name:JIMENEZ, EMIRCE
Entity Type:Individual
Prefix:MS
First Name:EMIRCE
Middle Name:
Last Name:JIMENEZ
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 1:777 N 1ST ST
Mailing Address - Street 2:#444
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-6337
Mailing Address - Country:US
Mailing Address - Phone:408-240-0070
Mailing Address - Fax:408-240-0077
Practice Address - Street 1:777 N 1ST ST
Practice Address - Street 2:#444
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6337
Practice Address - Country:US
Practice Address - Phone:408-240-0070
Practice Address - Fax:408-240-0077
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health