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NPI Code Detail

MEDICARE: MR. DAVID J HERNANDEZ LCSW

MEDICARE: MR. DAVID J 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
1225400000XRehabilitation Practitioner
2390200000XStudent in an Organized Health Care Education/Training Program
31041C0700XClinical Social WorkerLCSW107235CA
4101YM0800XMental Health CounselorASW84593CA
51041C0700XClinical Social WorkerASW84593CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821114232
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID J HERNANDEZ LCSW
Provider Business Mailing Address
First Line : 1849 SAWTELLE BLVD
Second Line : SUITE 610
City : LOS ANGELES
State : CA
Zip : 90025-7013
Country : US
Telephone Number : 424-261-5166
Fax Number :
Provider Business Practice Location Address
First Line : 1849 SAWTELLE BLVD STE 610
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-7013
Country : US
Telephone Number : 424-261-5166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 02/02/2023

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