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General NPI Number Information
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NPI Number | 1619335643
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Entity Type | Individual
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Provider Name | NICHOLETTE HERNANDEZ M.S. LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 07/22/2021
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Provider Practice Location Address
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Address Line | 14545 SHERMAN CIR
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City | VAN NUYS
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State | CA
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Zip | 91405-3087
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Country | US
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Telephone | 818-901-4854
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Fax |
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Provider Business Mailing Address
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Address Line | 8045 WENTWORTH ST
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City | SUNLAND
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State | CA
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Zip | 91040-2138
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Country | US
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Telephone | 818-395-4418
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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 | 73201
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 109954
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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 | 125740
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License Number State | CA
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