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NPI Code Detail

MEDICARE: CYNTHIA R HERNANDEZ LMFT

MEDICARE: CYNTHIA R HERNANDEZ LMFT
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
1171M00000XCase Manager/Care Coordinator77267CA
2106H00000XMarriage & Family Therapist77267CA

General Provider Information

NPI Number : 1194863068
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA R HERNANDEZ LMFT
Provider Business Mailing Address
First Line : PO BOX 2077
Second Line :
City : UKIAH
State : CA
Zip : 95482-2077
Country : US
Telephone Number : 707-467-2010
Fax Number :
Provider Business Practice Location Address
First Line : 350 E GOBBI ST
Second Line :
City : UKIAH
State : CA
Zip : 95482-5511
Country : US
Telephone Number : 707-467-2010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2007
Last Update Date : 04/30/2020

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