Provider Demographics
NPI:1336448752
Name:HERNANDEZ, SONIA MARICRUZ
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:MARICRUZ
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:MARIACRUZ
Other - Last Name:LOERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1399 W 34TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3659
Mailing Address - Country:US
Mailing Address - Phone:907-720-8011
Mailing Address - Fax:907-929-5858
Practice Address - Street 1:1399 W 34TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3659
Practice Address - Country:US
Practice Address - Phone:907-720-8011
Practice Address - Fax:907-929-5858
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion