Healthcare Provider Details

I. General information

NPI: 1952785461
Provider Name (Legal Business Name): P SHEHANIE RAMIKA HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PSHEHANIE RAMIKA HEWAWASAM

II. Dates (important events)

Enumeration Date: 07/14/2015
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 RAMONA BLVD STE E
IRWINDALE CA
91706-3752
US

IV. Provider business mailing address

13001 RAMONA BLVD STE E
IRWINDALE CA
91706-3752
US

V. Phone/Fax

Practice location:
  • Phone: 626-480-8107
  • Fax:
Mailing address:
  • Phone: 626-480-8107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT104512
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT199599
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: