Provider Demographics
NPI:1821506296
Name:HSIAO, JENNIFER (CADC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HSIAO
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 LAKESIDE CT STE 101
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4862
Mailing Address - Country:US
Mailing Address - Phone:775-786-6880
Mailing Address - Fax:775-786-6899
Practice Address - Street 1:3500 LAKESIDE CT STE 101
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4862
Practice Address - Country:US
Practice Address - Phone:775-786-6880
Practice Address - Fax:775-786-6899
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00812-C101YA0400X
NV02275-I101YA0400X
NV06882-L101YA0400X
NV9348-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1457515850Medicaid