Provider Demographics
NPI:1326670647
Name:HERNANDEZ, CLAUDIA YVETTE (MA)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:YVETTE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:Y
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43520 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-4089
Mailing Address - Country:US
Mailing Address - Phone:661-266-4783
Mailing Address - Fax:
Practice Address - Street 1:2502 E. HUNTINGTON DR.
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2725
Practice Address - Country:US
Practice Address - Phone:262-639-1336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X, 225400000X
CAAPCC11026101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner