Provider Demographics
NPI:1003252172
Name:HERANNDEZ, ROSA MARIA
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:MARIA
Last Name:HERANNDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8041 NEWMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7034
Mailing Address - Country:US
Mailing Address - Phone:714-500-0224
Mailing Address - Fax:
Practice Address - Street 1:8041 NEWMAN AVE.
Practice Address - Street 2:
Practice Address - City:HUNTIGNTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647
Practice Address - Country:US
Practice Address - Phone:714-500-0256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator