# JACOB VICENTE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1316689078
- **Gender:** Man
- **Credential:** DNP, PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0500X | Hemodialysis Registered Nurse | RN2309147 | MA | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 14685 | CT | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | RN2309147 | MA | — |

## Other

- **Enumeration date:** 04/12/2022
- **Last updated:** 06/24/2025