Individual
EDGAR HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, MPH
Contact information
Practice address
470 CHADBOURNE RD STE E, FAIRFIELD, CA 94534-9620
(707) 425-9670
(707) 425-9880
Mailing address
5222 COSUMNES DR APT 132, STOCKTON, CA 95219-7213
(310) 879-7576
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
10/07/2014
Last updated
03/09/2015
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