Individual
ANTHONY JACOB HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT
Contact information
Practice address
1777 BUCKMAN SPRINGS RD, CAMPO, CA 91906-2022
(619) 478-5696
(619) 478-2404
Mailing address
1777 BUCKMAN SPRINGS RD, CAMPO, CA 91906-2022
(619) 478-5696
(619) 478-2404
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1573180824
CA
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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