Provider Demographics
NPI:1417175324
Name:JIMENEZ SAFIR, PAULA B
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:B
Last Name:JIMENEZ SAFIR
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 1:7710 BALBOA AVE
Mailing Address - Street 2:STE 227C
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2253
Mailing Address - Country:US
Mailing Address - Phone:858-279-4079
Mailing Address - Fax:858-279-4079
Practice Address - Street 1:7710 BALBOA AVE
Practice Address - Street 2:STE 227C
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2253
Practice Address - Country:US
Practice Address - Phone:858-279-4079
Practice Address - Fax:858-279-4079
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15889103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical