Provider Demographics
NPI:1891035259
Name:JIMENEZ, MEGAN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MERRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 E COMMONWEALTH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1905
Mailing Address - Country:US
Mailing Address - Phone:714-773-4111
Mailing Address - Fax:
Practice Address - Street 1:140 E COMMONWEALTH AVE STE 101
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1905
Practice Address - Country:US
Practice Address - Phone:714-773-4111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist