Individual
BRENDA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9901 ARTESIA BLVD, BELLFLOWER, CA 90706-6713
(562) 484-3385
Mailing address
16438 GEORGIA AVE, PARAMOUNT, CA 90723-5506
(562) 441-9719
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1512013461
—
CA
Enumeration date
04/04/2012
Last updated
04/04/2012
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