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General NPI Number Information
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NPI Number | 1366573347
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Entity Type | Individual
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Provider Name | LYDIA MARIE JOSEPH-HERNANDEZ PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 12/04/2009
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Provider Practice Location Address
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Address Line | 2010 ZONAL 3-P-61
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City | LOS ANGELES
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State | CA
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Zip | 90033
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Country | US
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Telephone | 323-226-6767
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Fax | 323-226-3902
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Provider Business Mailing Address
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Address Line | 8617 WORTHINGTON DR.
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City | SAN GABRIEL
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State | CA
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Zip | 91775
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Country | US
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Telephone | 626-327-6327
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY19896
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 19896
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 31916
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License Number State | CA
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