Provider Demographics
NPI:1700903275
Name:HERNANDEZ-MALDONADO, ESPERANZA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ESPERANZA
Middle Name:
Last Name:HERNANDEZ-MALDONADO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3151 AIRWAY AVE
Mailing Address - Street 2:SUITE T3
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4607
Mailing Address - Country:US
Mailing Address - Phone:562-900-5006
Mailing Address - Fax:714-957-1335
Practice Address - Street 1:3151 AIRWAY AVE
Practice Address - Street 2:SUITE T3
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4607
Practice Address - Country:US
Practice Address - Phone:562-900-5006
Practice Address - Fax:714-957-1335
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 44197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health