Provider Demographics
NPI:1932414331
Name:JIMENEZ-ARREDONDO, ASHLEY ERIKA
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ERIKA
Last Name:JIMENEZ-ARREDONDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ERIKA
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23281 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-7227
Mailing Address - Country:US
Mailing Address - Phone:858-334-5502
Mailing Address - Fax:
Practice Address - Street 1:21030 MISSION ST
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-6769
Practice Address - Country:US
Practice Address - Phone:858-334-5502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86039106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist