Provider Demographics
NPI:1811068992
Name:HERNANDEZ, LUCIA CONTRERAS (MFT)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:CONTRERAS
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:LUCIA
Other - Middle Name:C
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, MA, MFT
Mailing Address - Street 1:PO BOX 1934
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92085-1934
Mailing Address - Country:US
Mailing Address - Phone:760-726-1215
Mailing Address - Fax:760-758-1766
Practice Address - Street 1:122 ESCONDIDO AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-6040
Practice Address - Country:US
Practice Address - Phone:760-726-1215
Practice Address - Fax:760-758-1766
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 33405101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional