Individual
CECILIA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
167G00000X
Contact information
Practice address
780 E GILBERT ST, SAN BERNARDINO, CA 92415-1003
(909) 763-4760
Mailing address
780 E GILBERT ST, SAN BERNARDINO, CA 92415-1003
(909) 763-4760
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41761
CA
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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