Provider Demographics
NPI:1467649244
Name:TRIANA, JAMES HERNAN JR (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HERNAN
Last Name:TRIANA
Suffix:JR
Gender:M
Credentials:PHD, LCSW
Other - Prefix:DR
Other - First Name:SANTIAGO
Other - Middle Name:HERNAN
Other - Last Name:TRIANA
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9000 JACARANDA LN
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3600
Mailing Address - Country:US
Mailing Address - Phone:954-663-1837
Mailing Address - Fax:954-473-9525
Practice Address - Street 1:7369 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2776
Practice Address - Country:US
Practice Address - Phone:954-663-1837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW000042791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ7123OtherBLUECROSS/BLUESHIELD