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NPI Code Detail

MEDICARE: MS. ANDREA HERNANDEZ LCSW

MEDICARE: MS. ANDREA HERNANDEZ LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor112385CA
2104100000XSocial Worker112385CA

General Provider Information

NPI Number : 1801382080
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANDREA HERNANDEZ LCSW
Provider Business Mailing Address
First Line : 1520 N RAYMOND AVE
Second Line :
City : PASADENA
State : CA
Zip : 91103-1819
Country : US
Telephone Number : 626-396-5920
Fax Number :
Provider Business Practice Location Address
First Line : 1520 N RAYMOND AVE
Second Line :
City : PASADENA
State : CA
Zip : 91103-1819
Country : US
Telephone Number : 626-652-2723
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2018
Last Update Date : 03/12/2026

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