Provider Information for 1366101255
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Dr. SARAH ANN JIMENEZ LCSW, PhD
Sex: Female
NPI: 1366101255
Last Updated: 2023-08-11
Certification Date: 2023-08-11
Certification Date: 2023-08-11
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1366101255 | ||||||||||||
| Enumeration Date | 2021-12-08 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2718 TELEGRAPH AVE STE 102 BERKELEY, CA 94705-1142 United States Phone: 415-948-3450 | Fax: | ||||||||||||
| Primary Practice Address | 2718 TELEGRAPH AVE STE 102 BERKELEY, CA 94705-1142 United States Phone: 415-948-3450 | Fax: | ||||||||||||
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