Provider Demographics
NPI:1255682860
Name:HERNANDEZ, DANIELA VELA
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:VELA
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:PO BOX 642
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92244-0642
Mailing Address - Country:US
Mailing Address - Phone:619-823-3686
Mailing Address - Fax:
Practice Address - Street 1:668 LEE RD
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-9502
Practice Address - Country:US
Practice Address - Phone:619-356-3136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor