Provider Demographics
NPI:1982046033
Name:HERNANDEZ, ABRAHAM CEPE JR
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:CEPE
Last Name:HERNANDEZ
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 NAMAUU PL
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-9105
Mailing Address - Country:US
Mailing Address - Phone:808-214-8091
Mailing Address - Fax:
Practice Address - Street 1:94 NAMAUU PL
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-9105
Practice Address - Country:US
Practice Address - Phone:808-214-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst