| Doctor Name: | MRS. ANGIE HERNANDEZ |
| NPI Number: | 1275755282 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | COUNSELOR |
| License Number: | H0412291731 |
| Business Practice Address: | 827 Colorado Avenue Los Banos, CA - 93635 |
| Business Phone Number: | 2097106110 |
| Business Fax Number: | 2098272001 |
| Mailing Address: | 663 Kensington Circle, LOS BANOS |
| State: | CA |
| Postal Code: | 93635 |
| Phone Number: | 2098279293 |
| Fax Number: | |
| NPI Enumeration Date: | 05/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | H0412291731 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |