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General NPI Number Information
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NPI Number | 1235444720
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Entity Type | Individual
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Provider Name | JENNIFER ROSE HERRERA LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 08/10/2010
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Provider Practice Location Address
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Address Line | 5570 KISSING OAK ST
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City | SAN ANTONIO
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State | TX
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Zip | 78247-1510
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Country | US
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Telephone | 210-535-9427
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Fax | 210-657-3876
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Provider Business Mailing Address
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Address Line | PO BOX 40362
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City | SAN ANTONIO
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State | TX
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Zip | 78229-1362
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Country | US
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Telephone | 210-535-9427
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Fax | 210-657-3876
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 53489
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License Number State | TX
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