Provider Demographics
NPI:1265620710
Name:HERNANDEZ, ANDRIA SUE (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDRIA
Middle Name:SUE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ANDRIA
Other - Middle Name:SUE
Other - Last Name:CHATFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22600 SAVI RANCH PKWY STE A3
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-4606
Mailing Address - Country:US
Mailing Address - Phone:714-745-2268
Mailing Address - Fax:
Practice Address - Street 1:22600 SAVI RANCH PKWY STE A3
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-4606
Practice Address - Country:US
Practice Address - Phone:714-745-2268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 103G00000X, 103TB0200X, 103TC2200X
CAPSY27372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty