Healthcare Provider Details

I. General information

NPI: 1487029435
Provider Name (Legal Business Name): ANA MARIA DE JESUS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANA MARIA HERNANDEZ MSW

II. Dates (important events)

Enumeration Date: 12/02/2015
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5776 STONERIDGE MALL RD STE 300
PLEASANTON CA
94588-4522
US

IV. Provider business mailing address

3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US

V. Phone/Fax

Practice location:
  • Phone: 855-501-1004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number71894
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: