MEDICARE: MARITZA G HERNANDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1063923431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARITZA G HERNANDEZ

Provider Business Mailing Address
First Line	:	320 HAYES ST APT C
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93906-3660
Country	:	US
Telephone Number	:	831-776-3557
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 W MARKET ST
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93901-2655
Country	:	US
Telephone Number	:	831-758-0181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2017
Last Update Date	:	10/12/2017

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Directions to “ MARITZA G HERNANDEZ ” Practice Location

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