Gustavo Jimenez-Fregoso
Counselor, School in Escalon, CA. Individual provider (NPI-1).
NPI number1215782875
StatusActive
Last updated in NPPESApr 18, 2024
Details
- NPI
- 1215782875
- Entity type
- Individual (NPI-1)
- Name
- Gustavo Jimenez-Fregoso
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 18, 2024
- Certification date
- Apr 18, 2024
- Last updated
- Apr 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YS0200X | Counselor, School | – | CA | Yes |
Practice location
1528 Yosemite AveEscalon, CA 95320-1753
Phone 209-691-9864
Mailing address
1528 Yosemite AveEscalon, CA 95320-1797
Phone 209-691-9864
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