Basic Information
Provider Information
NPI: 1275780272
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HERNANDEZ
FirstName: ADRIANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9101 WHITTIER BLVD
Address2:  
City: PICO RIVERA
State: CA
PostalCode: 906602405
CountryCode: US
TelephoneNumber: 5628014626
FaxNumber: 5628014630
Practice Location
Address1: 1721 GRIFFIN AVE
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900313312
CountryCode: US
TelephoneNumber: 3232214134
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/20/2008
LastUpdateDate: 04/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XIMF 62445CAN Behavioral Health & Social Service ProvidersMarriage & Family Therapist 
106H00000X103788CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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