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NPI Code Detail

MEDICARE: JENNY M HERNANDEZ-SANCHEZ LCSW

MEDICARE: JENNY M HERNANDEZ-SANCHEZ LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW-188994AZ

General Provider Information

NPI Number : 1154916971
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY M HERNANDEZ-SANCHEZ LCSW
Provider Business Mailing Address
First Line : PO BOX 633
Second Line :
City : LAVEEN
State : AZ
Zip : 85339-0633
Country : US
Telephone Number : 602-410-4399
Fax Number :
Provider Business Practice Location Address
First Line : 3314 W CATALINA DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-5291
Country : US
Telephone Number : 602-410-4399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2021
Last Update Date : 05/21/2024

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