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General NPI Number Information
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NPI Number | 1962719948
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Entity Type | Individual
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Provider Name | ROCHELLE TRACIE HERNANDEZ CA
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Gender | Female
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Dates
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Enumeration Date | 09/11/2010
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 737 FAWCETT AVE
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City | TACOMA
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State | WA
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Zip | 98402-5503
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Country | US
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Telephone | 253-396-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 NE RIDDELL RD STE 110
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City | BREMERTON
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State | WA
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Zip | 98310-3005
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Country | US
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Telephone | 360-228-2959
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Fax | 916-473-5766
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | B001910425
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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 | CG61556263
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CP61644865
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License Number State | WA
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