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General NPI Number Information
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NPI Number | 1760200489
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Entity Type | Individual
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Provider Name | ZULEICA HERNANDEZ BSW, CHW
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Gender | Female
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 405 W MICHIGAN AVE
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City | KALAMAZOO
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State | MI
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Zip | 49007-3747
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Country | US
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Telephone | 269-633-9521
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Fax |
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Provider Business Mailing Address
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Address Line | 927 RUSSELL ST
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City | KALAMAZOO
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State | MI
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Zip | 49001-3036
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Country | US
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Telephone | 269-532-8475
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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