Provider Demographics
NPI:1770228959
Name:HERNANDEZ MORENO, MARIA ISABEL (CFY-SLP)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ISABEL
Last Name:HERNANDEZ MORENO
Suffix:
Gender:F
Credentials:CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 RABE ST
Mailing Address - Street 2:
Mailing Address - City:FIREBAUGH
Mailing Address - State:CA
Mailing Address - Zip Code:93622-9775
Mailing Address - Country:US
Mailing Address - Phone:559-270-3366
Mailing Address - Fax:
Practice Address - Street 1:2505 W SHAW AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3334
Practice Address - Country:US
Practice Address - Phone:559-228-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15404235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist