Provider Demographics
NPI:1750736807
Name:HERNANDEZ RODRIGUEZ, ADAM (LMFT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HERNANDEZ RODRIGUEZ
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:ADAM
Other - Middle Name:
Other - Last Name:HERNANDEZ-RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:13585 SAN PABLO AV
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-7657
Mailing Address - Country:US
Mailing Address - Phone:415-519-2141
Mailing Address - Fax:
Practice Address - Street 1:13585 SAN PABLO AV
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-7657
Practice Address - Country:US
Practice Address - Phone:510-942-4700
Practice Address - Fax:510-942-4776
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 92018106H00000X
CA122149106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist