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Individual

MISS RIA PANTONIAL HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APCC

Contact information

Practice address
5325 BRODER BLVD, DUBLIN, CA 94568-3309
(925) 395-2704
Mailing address
5325 BRODER BLVD, DUBLIN, CA 94568-3309

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
18405
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0136
CA
05
0336
CA
Enumeration date
10/18/2017
Last updated
02/04/2025
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