Provider Demographics
NPI:1124600903
Name:HERNANDEZ, AMBER (MA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2938 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-2801
Mailing Address - Country:US
Mailing Address - Phone:267-909-8550
Mailing Address - Fax:
Practice Address - Street 1:2938 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-2801
Practice Address - Country:US
Practice Address - Phone:267-909-8550
Practice Address - Fax:267-909-8552
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health