Provider Demographics
NPI:1770040826
Name:HERNANDEZ, YASMIN (MS-CCC SLP)
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MS-CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 342
Mailing Address - Street 2:
Mailing Address - City:RIO VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:94571-0342
Mailing Address - Country:US
Mailing Address - Phone:916-601-5254
Mailing Address - Fax:925-281-5656
Practice Address - Street 1:PO BOX 342
Practice Address - Street 2:
Practice Address - City:RIO VISTA
Practice Address - State:CA
Practice Address - Zip Code:94571-0342
Practice Address - Country:US
Practice Address - Phone:916-601-5254
Practice Address - Fax:925-281-5656
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP17039235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist