Healthcare Provider Details

I. General information

NPI: 1023347952
Provider Name (Legal Business Name): WENDY NOHEMY HERNANDEZ ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2009
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5628 E SLAUSON AVE
COMMERCE CA
90040
US

IV. Provider business mailing address

5628 E SLAUSON AVE
COMMERCE CA
90040-2922
US

V. Phone/Fax

Practice location:
  • Phone: 323-318-9960
  • Fax: 323-780-3211
Mailing address:
  • Phone: 323-318-9960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number133366
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number66313
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number101566
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: