Individual
ATHENIZ HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11741 TELEGRAPH RD, SANTA FE SPRINGS, CA 90670-3681
(562) 803-0318
Mailing address
11741 TELEGRAPH RD, SANTA FE SPRINGS, CA 90670-3681
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
CA
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
CA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
0
CA
01
—
00000
00000
—
Enumeration date
08/15/2017
Last updated
10/11/2017
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