Provider Demographics
NPI:1922533850
Name:HERNANDEZ, ABIGAIL KATHRINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:KATHRINE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 YELLOWSTONE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-5884
Mailing Address - Country:US
Mailing Address - Phone:530-345-1600
Mailing Address - Fax:
Practice Address - Street 1:130 YELLOWSTONE DR STE 100
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-5884
Practice Address - Country:US
Practice Address - Phone:530-345-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-28
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAS79102101YM0800X
101YM0800X
CA1060461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health