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General NPI Number Information
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NPI Number | 1497282883
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Entity Type | Individual
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Provider Name | ALEXANDRA M HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | 2180 JOHNSON AVE
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-4558
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Country | US
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Telephone | 805-781-4804
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4621
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City | PASO ROBLES
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State | CA
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Zip | 93447-4621
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Country | US
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Telephone | 805-781-4804
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT111037
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License Number State | CA
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