Provider Demographics
NPI:1457795833
Name:JIMENEZ, AARON JOSEPH (MA)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:JOSEPH
Last Name:JIMENEZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 E SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-1588
Mailing Address - Country:US
Mailing Address - Phone:970-589-1649
Mailing Address - Fax:
Practice Address - Street 1:2956 NORTH AVE STE 6
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-3919
Practice Address - Country:US
Practice Address - Phone:970-589-1649
Practice Address - Fax:970-985-8036
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000539101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)