Hernandez-Codallos, Juan Jose

Hernandez-Codallos, Juan Jose is an individual health care provider with primary practice located at 615 Roger Canyon Rd , Laramie WY 82072-8902. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Hernandez-Codallos, Juan Jose can be contacted via phone (209) 918-8761.

Contact Information

Primary practice address
615 Roger Canyon Rd Laramie WY 82072-8902
Phone: (209) 918-8761
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 92529 California

Profile Details

NPI number 1740613306
LBN Legal business name Hernandez-Codallos, Juan Jose
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2013
Last updated Jul 31st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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