Basic Information
| Provider Information | |||||||||
| NPI: | 1104940303 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HERNANDEZ | ||||||||
| FirstName: | HORTENCIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1904 LANSDOWNE AVE | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900324109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232225808 | ||||||||
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| Practice Location | |||||||||
| Address1: | 838 E 6TH ST | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900211028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2136238446 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 08/29/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | ASW22409 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.