Healthcare Provider Details
I. General information
NPI: 1023926052
Provider Name (Legal Business Name): AMANECER MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5439 9TH AVE
LOS ANGELES CA
90043-2521
US
IV. Provider business mailing address
5439 9TH AVE
LOS ANGELES CA
90043-2521
US
V. Phone/Fax
- Phone: 909-293-9060
- Fax:
- Phone: 909-293-9060
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOSE
ALBERTO
HERNANDEZ
Title or Position: OWNER
Credential: PHD
Phone: 213-258-7290