Individual
JACOB PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 N SOLANO DR STE A, LAS CRUCES, NM 88001-2366
(575) 621-0217
Mailing address
809 S SAN PEDRO ST, LAS CRUCES, NM 88001-3634
(575) 312-0676
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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