Most Relevant Information
Provider Data
| NPI Number: | 1003679473 |
| Provider Name: | JACOB HERNANDEZ LAC |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: | 37AC00484200 |
Most Important Dates
| Enumeration Date: | 01/30/2024 |
| Last Updated: | 01/30/2024 |
Provider Practice Location
176 PALISADE AVE
JERSEY CITY
NJ
073061121
Practice Location Phone/Fax
| Phone: | 2017958200 |
| Fax: |
Provider Mailing Location
117 SHERMAN PL APT 1
JERSEY CITY
NJ
073073735
Provider Mailing Phone/Fax
| Phone: | 2016742876 |
| Fax: |