Healthcare Provider Details

I. General information

NPI: 1477095750
Provider Name (Legal Business Name): J&J PSYCHIATRIC ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2016
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5424 W HIGHWAY 290 STE 108
AUSTIN TX
78735-8827
US

IV. Provider business mailing address

5424 W HIGHWAY 290 STE 108
AUSTIN TX
78735-8827
US

V. Phone/Fax

Practice location:
  • Phone: 512-430-1130
  • Fax: 512-677-6806
Mailing address:
  • Phone: 512-430-1130
  • Fax: 512-677-6806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP121966
License Number StateTX

VIII. Authorized Official

Name: JESSICA HERNANDEZ
Title or Position: OWNER
Credential: PMHNP
Phone: 512-430-1130