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NPI Code Detail

MEDICARE: JENNIFER AYALA HERNANDEZ LCSW

MEDICARE: JENNIFER AYALA HERNANDEZ 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 Worker7922-SNV
21041C0700XClinical Social Worker9157-CNV

General Provider Information

NPI Number : 1811470990
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER AYALA HERNANDEZ LCSW
Provider Business Mailing Address
First Line : 680 S ROCK BLVD
Second Line :
City : RENO
State : NV
Zip : 89502-4113
Country : US
Telephone Number : 775-329-6300
Fax Number : 775-336-0652
Provider Business Practice Location Address
First Line : 680 S ROCK BLVD
Second Line :
City : RENO
State : NV
Zip : 89502-4113
Country : US
Telephone Number : 775-329-3003
Fax Number : 775-336-0653
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2018
Last Update Date : 09/13/2021

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