Doctor Name: | MR. JORGE REYNALDO HERNANDEZ |
NPI Number: | 1043581085 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | |
Business Practice Address: | 500 B Jefferson Blvd # 195 West Sacramento, CA - 956052350 |
Business Phone Number: | 9164032970 |
Business Fax Number: | |
Mailing Address: | 500 B Jefferson Blvd. #195, WEST SACRAMENTO |
State: | CA |
Postal Code: | 95605 |
Phone Number: | 9164032990 |
Fax Number: | |
NPI Enumeration Date: | 01/23/2012 |
NPI Last Update Date: | 09/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |