Healthcare Provider Details

I. General information

NPI: 1528646122
Provider Name (Legal Business Name): VIRGINIA RONDERO HERNANDEZ ACC, NBC-HWC, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VIRGINIA RONDERO HERNANDEZ ACC, NBC-HWC, LCSW

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1326 TAUBENFELD
SAN ANTONIO TX
78260-4459
US

IV. Provider business mailing address

1326 TAUBENFELD
SAN ANTONIO TX
78260-4459
US

V. Phone/Fax

Practice location:
  • Phone: 559-307-3740
  • Fax: 559-472-3313
Mailing address:
  • Phone: 559-307-3740
  • Fax: 559-472-3313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16449
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: