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General NPI Number Information
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NPI Number | 1316072416
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Entity Type | Individual
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Provider Name | RAQUEL A HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 220 W MAIN ST
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City | BRAWLEY
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State | CA
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Zip | 92227-2253
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Country | US
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Telephone | 760-351-3095
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Fax |
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Provider Business Mailing Address
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Address Line | 261 SANTA ROSA DR
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City | IMPERIAL
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State | CA
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Zip | 92251-8605
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Country | US
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Telephone |
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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