| Doctor Name: | JASON MICHAEL HERRERA |
| NPI Number: | 1104282607 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | IMF75058 |
| Business Practice Address: | 11741 Telegraph Rd Santa Fe Springs, CA - 906703681 |
| Business Phone Number: | 5629428256 |
| Business Fax Number: | |
| Mailing Address: | 5762 Lincoln Ave Unit 942, CYPRESS |
| State: | CA |
| Postal Code: | 906308249 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/13/2016 |
| NPI Last Update Date: | 02/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | IMF75058 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |