Provider Demographics
NPI:1023839446
Name:PIMENTAL, JAMES BRADLEY (RADT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BRADLEY
Last Name:PIMENTAL
Suffix:
Gender:M
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7571 W FLORENCE AVE
Mailing Address - Street 2:15
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291
Mailing Address - Country:US
Mailing Address - Phone:559-805-2143
Mailing Address - Fax:
Practice Address - Street 1:3107 E KAWEAH AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-3309
Practice Address - Country:US
Practice Address - Phone:559-754-2705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)