Basic Information
Provider Information
NPI: 1750619250
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HERNANDEZ
FirstName: BARBARA
MiddleName: ANN
NamePrefix: DR.
NameSuffix:  
Credential: LMFT, PSY. D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12440 FIRESTONE BLVD STE 201
Address2:  
City: NORWALK
State: CA
PostalCode: 906509323
CountryCode: US
TelephoneNumber: 5624500620
FaxNumber: 5623668423
Practice Location
Address1: 12440 FIRESTONE BLVD STE 201
Address2:  
City: NORWALK
State: CA
PostalCode: 90650
CountryCode: US
TelephoneNumber: 5624500620
FaxNumber: 5623668423
Other Information
ProviderEnumerationDate: 11/23/2009
LastUpdateDate: 12/14/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XLMFT46641CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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