Provider Demographics
NPI:1700637782
Name:HERNANDEZ, YASMIN OFELIA
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:OFELIA
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 1:49285 ORQUIDEA LN
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-3215
Mailing Address - Country:US
Mailing Address - Phone:619-208-5044
Mailing Address - Fax:
Practice Address - Street 1:49285 ORQUIDEA LN
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-3215
Practice Address - Country:US
Practice Address - Phone:619-208-5044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician