Provider Demographics
NPI:1184343964
Name:JAIMES, IBRIS GUADALUPE
Entity type:Individual
Prefix:
First Name:IBRIS
Middle Name:GUADALUPE
Last Name:JAIMES
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 1:1222 W LACEY BLVD
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5901
Mailing Address - Country:US
Mailing Address - Phone:559-415-6737
Mailing Address - Fax:559-422-6114
Practice Address - Street 1:1222 W LACEY BLVD
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5901
Practice Address - Country:US
Practice Address - Phone:559-235-9239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program