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General NPI Number Information
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NPI Number | 1720809106
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Entity Type | Individual
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Provider Name | MELODY MELINDA HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 1133 RIVER WOOD
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City | SEGUIN
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State | TX
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Zip | 78155-0083
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Country | US
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Telephone | 951-818-4421
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Fax |
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Provider Business Mailing Address
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Address Line | 1793 WREN AVE
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City | CORONA
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State | CA
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Zip | 92879-2939
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Country | US
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Telephone | 951-818-4421
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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 | LPCC17536
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License Number State | CA
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