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NPI Code Detail

MEDICARE: JENNIFER LAUREN HOCH RADT1

MEDICARE: JENNIFER LAUREN HOCH RADT1
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
1101YA0400XAddiction (Substance Use Disorder) Counselor15014-RACCA

General Provider Information

NPI Number : 1598421364
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LAUREN HOCH RADT1
Provider Business Mailing Address
First Line : 6265 SEPULVEDA BLVD STE 9
Second Line :
City : VAN NUYS
State : CA
Zip : 91411-1126
Country : US
Telephone Number : 818-779-0555
Fax Number : 818-779-0455
Provider Business Practice Location Address
First Line : 6265 SEPULVEDA BLVD STE 9
Second Line :
City : VAN NUYS
State : CA
Zip : 91411-1126
Country : US
Telephone Number : 818-779-0555
Fax Number : 818-779-0455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2021
Last Update Date : 11/16/2021

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Directions to “ JENNIFER LAUREN HOCH RADT1” Practice Location

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