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General NPI Number Information
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NPI Number | 1841590064
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Entity Type | Individual
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Provider Name | MR. ROGELIO HERNANDEZ-MELENDEZ
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Gender | Male
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 09/09/2016
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Provider Practice Location Address
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Address Line | 3751 STOCKER PL.
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City | LOS ANGELES
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State | CA
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Zip | 90008
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Country | US
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Telephone | 323-298-3680
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Fax |
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Provider Business Mailing Address
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Address Line | 3933 DALTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90062-0000
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Country | US
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Telephone | 323-236-4088
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 28976
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ASW28967
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW72959
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License Number State | CA
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