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General NPI Number Information
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NPI Number | 1487820171
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Entity Type | Individual
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Provider Name | CAMILLE ANN HERNANDEZ PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 65 EAST RUGGLES RD
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City | FLORENCE
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State | AZ
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Zip | 85232-2951
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Country | US
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Telephone | 480-310-8555
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Fax | 480-706-9449
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Provider Business Mailing Address
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Address Line | PO BOX 2951
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City | FLORENCE
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State | AZ
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Zip | 85232-2951
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Country | US
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Telephone | 480-208-3375
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Fax | 480-706-9449
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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 | 3939
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License Number State | AZ
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