Individual
JACOB A DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3055 WILSHIRE BLVD STE 300, LOS ANGELES, CA 90010-1147
(213) 375-3830
Mailing address
3055 WILSHIRE BLVD STE 300, LOS ANGELES, CA 90010-1147
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/03/2019
Last updated
03/26/2024
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