Provider Demographics
NPI:1518687318
Name:HERNANDEZ, LILIANA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LILIANA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JARDINES DE PONCE
Mailing Address - Street 2:PASEO CUNDEAMOR F-23
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:939-252-6958
Mailing Address - Fax:
Practice Address - Street 1:CALLE SALMON #55 E
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:939-413-8792
Practice Address - Fax:939-445-4011
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4127103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical