Individual
SUZETTE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3270 KERNER BLVD STE C, SAN RAFAEL, CA 94901-4840
(415) 457-4554
Mailing address
3270 KERNER BLVD STE C, SAN RAFAEL, CA 94901-4840
(415) 457-4554
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-LBSOFX
CA
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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