MARIO R JIMINEZ (NPI# 1528181070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528181070 |
| Entity Type | Individual |
| Full Name | MARIO R JIMINEZ |
| Practice Address |
507 F St Eureka CA 95501-1009 |
| Mailing Address |
30 W Simpson St Apt A Eureka CA 95501-5333 |
| Practice Telephone | 7074415510 |
| Practice Fax Number | 7074415581 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2010-05-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
507 F ST |
| City | EUREKA |
| State | CA |
| Zip Code | 95501-1009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538795919 | Eric Meyer Goldsmith | Physical Therapist | 2306 Dean Street, Eureka, CA 95501 | 2020-03-18 |
| 1609406404 | Humboldt County Behavioral Health | Community/Behavioral Health | 638 W Clark St., Bldg. E, Eureka, CA 95501 | 2020-01-21 |
| 1740831767 | Jacqueline Renee Coghill | Nurse Practitioner | Waterfront Recovery Services, 2413 2nd St, Eureka, CA 95501 | 2019-09-20 |
| 1982177275 | Jenny Bugnacki | Case Manager/Care Coordinator | 721 Wood St, Eureka, CA 95501 | 2019-01-09 |
| 1073023107 | Humboldt Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 1303 11th St, Eureka, CA 95501 | 2017-10-03 |
| 1730698283 | Gabriel Holtski | Naturopath | 1632 Broadway, Suite #252, Eureka, CA 95501 | 2017-09-27 |
| 1164951851 | Redwood Community Services, Inc. | Foster Care Agency | 2426 6th St, Eureka, CA 95501 | 2017-06-07 |
| 1033651922 | Narum Clinical Services | Social Worker | 930 3rd St, Suite 201, Eureka, CA 95501 | 2016-11-09 |
| 1750839510 | Sierra Marie Evers-hellmich | Physical Medicine & Rehabilitation | 2103 Myrtle Avenue, Eureka, CA 95501 | 2016-09-21 |
| 1558720623 | Jennifer Vu | Behavioral Analyst | 730 7th St Ste A, Eureka, CA 95501 | 2016-02-18 |
| Find all providers in zip 95501 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982177275 | Jenny Bugnacki | Case Manager/Care Coordinator | 721 Wood St, Eureka, CA 95501 | 2019-01-09 |
| 1427576487 | Liliana Alonso | Case Manager/Care Coordinator | 3960 Walnut Dr., Eureka, CA 95503 | 2017-08-30 |
| 1144673419 | Maria Nordmann | Case Manager/Care Coordinator | 4632 Meramec Blvd, Eureka, MO 63025-2300 | 2016-07-21 |
| 1801217369 | Dorlyn Woods | Case Manager/Care Coordinator | 2738 H St, Eureka, CA 95501-4404 | 2013-12-30 |
| 1780014845 | Emily Page Quackenbush | Case Manager/Care Coordinator | 3130 Lowell St, Eureka, CA 95503-5219 | 2013-11-26 |
| 1326389693 | Tiffany Maldonado | Case Manager/Care Coordinator | 921 S St, Eureka, CA 95501-2063 | 2013-03-11 |
| 1629320254 | Terra Yvette Hescock | Case Manager/Care Coordinator | 2413 2nd Street, Eureka, CA 95501 | 2012-10-05 |
| 1740506609 | Kathryn Maria Schell Walkley | Case Manager/Care Coordinator | 504 Silva Ave, Eureka, CA 95503-5108 | 2010-04-15 |
| 1174755250 | Tanya Parker | Case Manager/Care Coordinator | 2379 Myrtle Ave, Eureka, CA 95501-3327 | 2009-08-21 |
| 1902056633 | Pamela Christine Brown | Case Manager/Care Coordinator | 1910 California Street, Eureka, CA 95501-2870 | 2008-09-30 |
| Find all providers in EUREKA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.