Provider Demographics
NPI:1508039124
Name:HERNANDEZ, PETER (BA)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SILICON VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-1858
Mailing Address - Country:US
Mailing Address - Phone:408-284-9000
Mailing Address - Fax:408-284-9048
Practice Address - Street 1:455 SILICON VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-1858
Practice Address - Country:US
Practice Address - Phone:408-284-9000
Practice Address - Fax:408-284-9048
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health