Provider Demographics
NPI:1700966793
Name:HERNANDEZ, ROSSANA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ROSSANA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ROSSANA
Other - Middle Name:DIAZ
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 4291
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90607-4291
Mailing Address - Country:US
Mailing Address - Phone:562-777-5303
Mailing Address - Fax:
Practice Address - Street 1:201 CENTRE PLAZA DR
Practice Address - Street 2:SUITE 425
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-2142
Practice Address - Country:US
Practice Address - Phone:323-526-6435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 271011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical