Individual
BRENDA HERNANDEZ BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 W 6TH ST STE 230, SAN PEDRO, CA 90731-3332
(310) 833-3135
(310) 707-2877
Mailing address
1301 PINE AVE, LONG BEACH, CA 90813-3124
(562) 595-1159
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ACSW90551
CA
Other
Enumeration date
07/24/2018
Last updated
05/03/2022
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