Provider Demographics
NPI:1457657157
Name:HERNANDEZ, JUAN PABLO (GUIDANCE/COUNCELOR)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:PABLO
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:GUIDANCE/COUNCELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 SAVANNAH AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-4432
Mailing Address - Country:US
Mailing Address - Phone:915-244-1787
Mailing Address - Fax:
Practice Address - Street 1:3465 MCNUTT RD
Practice Address - Street 2:
Practice Address - City:SUNLAND PARK
Practice Address - State:NM
Practice Address - Zip Code:88063-9056
Practice Address - Country:US
Practice Address - Phone:575-915-1338
Practice Address - Fax:575-915-1819
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty