DANIEL JIMMERSON (NPI# 1609498542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609498542 |
| Entity Type | Individual |
| Full Name | DANIEL JIMMERSON |
| Credential | CADC |
| Practice Address |
20331 Flanagan Road Trabuco Canyon CA 92679 |
| Mailing Address |
21951 Rimhurst Dr Unit J Lake Forest CA 92630-5971 |
| Practice Telephone | 8185828832 |
| Practice Fax Number | 8185828836 |
| Mailing Telephone | 9495665039 |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-05-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CI21171218 | CA | Behavioral Health & Social Service Providers |
| Street Address |
20331 FLANAGAN ROAD |
| City | TRABUCO CANYON |
| State | CA |
| Zip Code | 92679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245831817 | Alexis T Fritkin | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-11-02 |
| 1740889880 | Andrea Clark Carmona | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-10-20 |
| 1629683495 | Paeton Mckenzie Bruno | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-09-09 |
| 1801404322 | Janet Fata | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-07-21 |
| 1114544004 | Atlanta Danielle St.martin | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-06-26 |
| 1205453123 | Savana Joy Mcgregor | Licensed Vocational Nurse | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-06-26 |
| 1922624196 | Michelle Wilson | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-06-23 |
| 1831715192 | Penny Jennifer Ann Crisostomo | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-06-23 |
| 1447875844 | Alyssa Natalie Martin | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-06-11 |
| 1710501580 | Brianne Leslie Wilson | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841839834 | Natalia Locati | Technician, Other | 20338 Flanagan Rd, Rancho Santa Margarita, CA 92679 | 2019-12-23 |
| 1720620289 | Shaley Gupta | Pharmacist | 21 Centaurus Way, Coto De Caza, CA 92679 | 2019-10-16 |
| 1598135147 | Jenna Lynn Zottarelli | Counselor | 20342 Flanagan Road, Trabuco Canyon, CA 92679 | 2015-09-25 |
| 1033596226 | Kristina Murphy | Counselor | 100 Via Candelaria, Coto De Caza, CALIFORNIA 92679 | 2015-04-27 |
| 1467790576 | Lucito Gamboa Gamboa | Family Medicine | 18 Golfview Drive, Dove Canyon, CA 92679 | 2013-01-24 |
| 1235407131 | Karen Ebersole Rippy | Marriage & Family Therapist | 20331 Flanagan Rd., Trabuco Canyon, CA 92679 | 2011-12-06 |
| 1255655916 | Lyndsay Allison Bulger | Registered Nurse | 15 Glen Echo, Dove Canyon, CA 92679 | 2010-03-23 |
| 1235393133 | Kalapp Chiropractic | Chiropractor | 20061 Trabuco Oaks, Trabuco Canyon, CA 92679 | 2008-07-10 |
| 1760650071 | Reha C Shrikhande | Physical Therapist | 8 Yellowpine Lane, Trabuco Cyn, CA 92679 | 2008-02-20 |
| 1013012343 | Robert J Foster | Physical Therapist | 28351 Quiet Hill Lane, Trabuco Canyon, CA 92679 | 2006-09-13 |
| Find all providers in zip 92679 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306070 | Courtney Alexis Crisostomo | Counselor | 20331 Flanagan Rd., Trabuco Canyon, CA 92679 | 2020-11-04 |
| 1245831817 | Alexis T Fritkin | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-11-02 |
| 1740889880 | Andrea Clark Carmona | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-10-20 |
| 1659979599 | Christina Marie Kayanan | Counselor | 20342 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-10-13 |
| 1629683495 | Paeton Mckenzie Bruno | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-09-09 |
| 1801404322 | Janet Fata | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-07-21 |
| 1114544004 | Atlanta Danielle St.martin | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-06-26 |
| 1922624196 | Michelle Wilson | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-06-23 |
| 1831715192 | Penny Jennifer Ann Crisostomo | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-06-23 |
| 1447875844 | Alyssa Natalie Martin | Counselor | 20331 Flanagan Road, Trabuco Canyon, CA 92679 | 2020-06-11 |
| Find all providers in TRABUCO CANYON | ||||
| City | TRABUCO CANYON |
| Zip Code | 92679 |
Please comment or provide details below to improve the information on DANIEL JIMMERSON.
| 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.