Basic Information
| Provider Information | |||||||||
| NPI: | 1629577077 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HERNANDEZ PEREZ | ||||||||
| FirstName: | JANET | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 631277 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452631277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164729854 | ||||||||
| FaxNumber: | 9164150120 | ||||||||
| Practice Location | |||||||||
| Address1: | 4200 ROCKLIN RD STE 11B | ||||||||
| Address2: | |||||||||
| City: | ROCKLIN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956772860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164729854 | ||||||||
| FaxNumber: | 9164150120 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2018 | ||||||||
| LastUpdateDate: | 07/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-21-50868 | CA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.