Provider Demographics
NPI:1497030647
Name:LEONEL J. JIMENEZ RN-CNOR-RNFA
Entity Type:Organization
Organization Name:LEONEL J. JIMENEZ RN-CNOR-RNFA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONEL
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN-CNOR-RNFA
Authorized Official - Phone:530-227-6980
Mailing Address - Street 1:2748 IVY HILL CT
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1704
Mailing Address - Country:US
Mailing Address - Phone:530-221-8343
Mailing Address - Fax:
Practice Address - Street 1:2748 IVY HILL CT
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1704
Practice Address - Country:US
Practice Address - Phone:530-221-8343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA600806282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital