Provider Demographics
NPI:1003936600
Name:HERNANDEZ, ALICIA BERUMEN
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:BERUMEN
Last Name:HERNANDEZ
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 1:68615 PEREZ RD
Mailing Address - Street 2:SUITE 6-A
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-7200
Mailing Address - Country:US
Mailing Address - Phone:760-770-2222
Mailing Address - Fax:760-770-2249
Practice Address - Street 1:68615 PEREZ RD
Practice Address - Street 2:SUITE 6-A
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7200
Practice Address - Country:US
Practice Address - Phone:760-770-2222
Practice Address - Fax:760-770-2249
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor