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NPI Code Detail

MEDICARE: MR. ANDRES HECTOR HERNANDEZ LCSW

MEDICARE: MR. ANDRES HECTOR HERNANDEZ LCSW
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
11041C0700XClinical Social WorkerLY 10131CA

General Provider Information

NPI Number : 1184706665
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDRES HECTOR HERNANDEZ LCSW
Provider Business Mailing Address
First Line : 2304 S ELECTRIC AVE
Second Line :
City : ALHAMBRA
State : CA
Zip : 91803-4518
Country : US
Telephone Number : 626-644-6573
Fax Number :
Provider Business Practice Location Address
First Line : 529 MAPLE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1511
Country : US
Telephone Number : 323-267-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/23/2013

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