Provider Demographics
NPI:1508154063
Name:JIMENEZ, MARIA ISABEL (BCBA)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ISABEL
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6160 CORNERSTONE CT E STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3724
Mailing Address - Country:US
Mailing Address - Phone:858-216-8837
Mailing Address - Fax:619-941-0276
Practice Address - Street 1:4055 TECHNOLOGY FOREST BLVD STE 100
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-2008
Practice Address - Country:US
Practice Address - Phone:832-463-2480
Practice Address - Fax:832-416-7577
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106E00000X
TX3294103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst