Provider Demographics
NPI:1881803435
Name:JIMENEZ, ALLISON YURIKO (OTR)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:YURIKO
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8541 PEACHTREE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-3343
Mailing Address - Country:US
Mailing Address - Phone:510-795-7386
Mailing Address - Fax:
Practice Address - Street 1:39022 PRESIDIO WAY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1221
Practice Address - Country:US
Practice Address - Phone:510-792-3743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1550225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist