Healthcare Provider Details

I. General information

NPI: 1811278740
Provider Name (Legal Business Name): MRS. MARIA HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2011
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 E LASSEN AVE
CHICO CA
95973-7823
US

IV. Provider business mailing address

1360 E LASSEN AVE
CHICO CA
95973-7823
US

V. Phone/Fax

Practice location:
  • Phone: 530-267-1700
  • Fax:
Mailing address:
  • Phone: 530-267-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW84833
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW84833
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW125934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: