Provider Demographics
NPI:1922737261
Name:HERNANDEZ, SUGEY ANAHI (COTA)
Entity Type:Individual
Prefix:
First Name:SUGEY
Middle Name:ANAHI
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17625 TULSA ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4613
Mailing Address - Country:US
Mailing Address - Phone:805-679-3257
Mailing Address - Fax:
Practice Address - Street 1:31822 VILLAGE CENTER RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4316
Practice Address - Country:US
Practice Address - Phone:818-532-7884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty