Healthcare Provider Details

I. General information

NPI: 1730635103
Provider Name (Legal Business Name): VALERIE HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2016
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 W WILLIAMS ST BLDG 1-3
LONG BEACH CA
90810-3636
US

IV. Provider business mailing address

2120 W WILLIAMS ST BLDG 1-3
LONG BEACH CA
90810-3636
US

V. Phone/Fax

Practice location:
  • Phone: 562-388-8118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-OFBNSZ
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: