Provider Demographics
NPI:1114482445
Name:MOLINA, HETTY
Entity Type:Individual
Prefix:MRS
First Name:HETTY
Middle Name:
Last Name:MOLINA
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 1:1410 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2503
Mailing Address - Country:US
Mailing Address - Phone:650-578-8691
Mailing Address - Fax:650-393-8925
Practice Address - Street 1:1410 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2503
Practice Address - Country:US
Practice Address - Phone:650-578-8691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty