Provider Demographics
NPI:1164961900
Name:HERNANDEZ, KATIA ANDREA
Entity Type:Individual
Prefix:
First Name:KATIA
Middle Name:ANDREA
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 1:1441 CONSTITUTION BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3127
Mailing Address - Country:US
Mailing Address - Phone:831-796-1700
Mailing Address - Fax:831-769-0552
Practice Address - Street 1:1441 CONSTITUTION BLVD STE 202
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3127
Practice Address - Country:US
Practice Address - Phone:831-796-1700
Practice Address - Fax:831-769-0552
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor