Basic Information
Provider Information
NPI: 1518371517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HINOJOSA SOBERANIS
FirstName: NANCY
MiddleName: JEANNETTE
NamePrefix: MRS.
NameSuffix:  
Credential: CAADE 122220
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HINOJOSA
OtherFirstName: NANCY
OtherMiddleName: JEANNETTE
OtherNamePrefix: MRS.
OtherNameSuffix:  
OtherCredential: CAADE 122220
OtherLastNameType: 5
Mailing Information
Address1: 11500 PARAMOUNT BLVD
Address2: LIVING WITH HOPE RESOURCE CENTER
City: DOWNEY
State: CA
PostalCode: 902414530
CountryCode: US
TelephoneNumber: 5629234545
FaxNumber:  
Practice Location
Address1: 11500 PARAMOUNT BLVD
Address2: LIVING WITH HOPE RESOURCE CENTER
City: DOWNEY
State: CA
PostalCode: 92041
CountryCode: US
TelephoneNumber: 5629234545
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/17/2014
LastUpdateDate: 02/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X122220CAY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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