Provider Demographics
NPI:1275416794
Name:JIMENEZ, LIZETTE SALDIVAR
Entity type:Individual
Prefix:MRS
First Name:LIZETTE
Middle Name:SALDIVAR
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2946 W PEREZ AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-8542
Mailing Address - Country:US
Mailing Address - Phone:559-303-3566
Mailing Address - Fax:
Practice Address - Street 1:5000 W CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8300
Practice Address - Country:US
Practice Address - Phone:559-802-0615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1203051041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool