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NPI Code Detail

MEDICARE: PRISCILLA LYNN HERNANDEZ LCSW

MEDICARE: PRISCILLA LYNN 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
1101YM0800XMental Health Counselor
21041C0700XClinical Social WorkerLCSW90762CA

General Provider Information

NPI Number : 1972938579
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRISCILLA LYNN HERNANDEZ LCSW
Provider Business Mailing Address
First Line : 55 SANTA CLARA AVE STE 200
Second Line :
City : OAKLAND
State : CA
Zip : 94610-1319
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 235 E BROADWAY STE 314
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-7801
Country : US
Telephone Number : 888-588-8995
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2013
Last Update Date : 02/23/2026

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