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General NPI Number Information
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NPI Number | 1033419874
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Entity Type | Individual
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Provider Name | DIANE HERNANDEZ PSY.D
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Gender | Female
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Dates
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Enumeration Date | 10/27/2010
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 5 HARVARD CIR SUITE 109
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-1979
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Country | US
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Telephone | 954-701-0418
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Fax |
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Provider Business Mailing Address
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Address Line | 143 MIRAMAR AVE
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1162
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Country | US
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Telephone | 954-701-0418
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY8625
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License Number State | FL
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