Provider Demographics
NPI:1407949126
Name:HERSHOWITZ, JONAH (LAC)
Entity Type:Individual
Prefix:
First Name:JONAH
Middle Name:
Last Name:HERSHOWITZ
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 MONTGOMERY ST STE 450
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-3475
Mailing Address - Country:US
Mailing Address - Phone:415-445-9388
Mailing Address - Fax:
Practice Address - Street 1:220 MONTGOMERY ST STE 450
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-3475
Practice Address - Country:US
Practice Address - Phone:415-445-9388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9538171100000X
CAAC9538171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist