Individual
ANNETTE JAQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4902 QUEENS BLVD, WOODSIDE, NY 11377-4444
(929) 296-6790
(929) 300-0280
Mailing address
310 SAINT NICHOLAS AVE, BROOKLYN, NY 11237-6566
(929) 296-6790
(929) 300-0280
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/03/2026
Last updated
02/07/2026
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