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NPI Code Detail

MEDICARE: VIVIAN HERNANDEZ

MEDICARE: VIVIAN 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
1101YA0400XAddiction (Substance Use Disorder) CounselorCA

General Provider Information

NPI Number : 1134369648
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVIAN HERNANDEZ
Provider Business Mailing Address
First Line : 155 BIMINI PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-5902
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 155 BIMINI PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-5902
Country : US
Telephone Number : 213-388-5423
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2009
Last Update Date : 04/11/2023

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Directions to “ VIVIAN HERNANDEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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