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General NPI Number Information
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NPI Number | 1295095719
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Entity Type | Individual
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Provider Name | AMPARO HERNANDEZ CMT
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Gender | Female
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Dates
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Enumeration Date | 05/17/2012
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 821 E 2ND ST #201C
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City | BENICIA
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State | CA
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Zip | 94510-3344
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Country | US
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Telephone | 707-980-7661
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Fax |
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Provider Business Mailing Address
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Address Line | 139 13TH ST
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City | VALLEJO
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State | CA
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Zip | 94590-7116
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Country | US
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Telephone | 707-333-3337
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 32840
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License Number State | CA
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