Healthcare Provider Details

I. General information

NPI: 1548148380
Provider Name (Legal Business Name): LOUIS ALONSO HERNANDEZ LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

876 APPLETON RD
SIMI VALLEY CA
93065-5115
US

IV. Provider business mailing address

876 APPLETON RD
SIMI VALLEY CA
93065-5115
US

V. Phone/Fax

Practice location:
  • Phone: 818-610-9458
  • Fax:
Mailing address:
  • Phone: 818-610-9458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number133281
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: