Healthcare Provider Details

I. General information

NPI: 1316291404
Provider Name (Legal Business Name): LAURA HERNANDEZ LMFT 152562
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2012
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 ANACAPA ST
SANTA BARBARA CA
93101-1615
US

IV. Provider business mailing address

PO BOX 4442
SANTA BARBARA CA
93140-4442
US

V. Phone/Fax

Practice location:
  • Phone: 805-964-8857
  • Fax:
Mailing address:
  • Phone: 805-636-6656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number152562
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: