Provider Demographics
NPI:1255521076
Name:HERNANDEZ, BETH
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 RIO LINDO AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1852
Mailing Address - Country:US
Mailing Address - Phone:530-895-6524
Mailing Address - Fax:530-896-0157
Practice Address - Street 1:564 RIO LINDO AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1852
Practice Address - Country:US
Practice Address - Phone:530-895-6524
Practice Address - Fax:530-896-0157
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker