Active NPI
Jacob Andrew Hernandez, CAC II
- Addiction (Substance Use Disorder) Counselor
- Northglenn, CO
National Provider Identifier
1912223355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- ACB 6822
- Practice address
- 11750 Lincoln St
Northglenn, CO 80233-1107 - Phone
- (303) 452-9133
- Fax
- (303) 452-9133
- NPI assigned
- Apr 9, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ACB 6822 | CO | Primary |
Addresses
Primary practice location
11750 Lincoln St
Northglenn, CO 80233-1107
Mailing address
11750 Lincoln St
Northglenn, CO 80233-1107
Phone (303) 452-9133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACB 6822 | CO | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270771200000",
"number": "1912223355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11750 LINCOLN ST",
"city": "NORTHGLENN",
"state": "CO",
"postal_code": "802331107",
"telephone_number": "303-452-9133",
"fax_number": "303-452-9133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11750 LINCOLN ST",
"city": "NORTHGLENN",
"state": "CO",
"postal_code": "802331107",
"telephone_number": "303-452-9133",
"fax_number": "303-452-9133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "JACOB",
"middle_name": "ANDREW",
"credential": "CAC II",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-09",
"last_updated": "2010-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "ACB 6822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northglenn, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.