Provider Demographics
NPI:1184706665
Name:HERNANDEZ, ANDRES HECTOR (LCSW)
Entity type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:HECTOR
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 S ELECTRIC AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-4518
Mailing Address - Country:US
Mailing Address - Phone:626-644-6573
Mailing Address - Fax:
Practice Address - Street 1:529 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1511
Practice Address - Country:US
Practice Address - Phone:323-267-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALY 101311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical