Provider Demographics
NPI:1467984807
Name:HERNANDEZ, DANNIA
Entity Type:Individual
Prefix:
First Name:DANNIA
Middle Name:
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 1:1891 N GAFFEY ST STE 221
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-1270
Mailing Address - Country:US
Mailing Address - Phone:424-570-0241
Mailing Address - Fax:
Practice Address - Street 1:1891 N GAFFEY ST STE 221
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-1270
Practice Address - Country:US
Practice Address - Phone:424-570-0241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator