Provider Demographics
NPI:1831878768
Name:HERNANDEZ, JULIO CESAR (EDD, LMFT)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:EDD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5365 FOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1013
Mailing Address - Country:US
Mailing Address - Phone:323-854-9300
Mailing Address - Fax:
Practice Address - Street 1:5365 FOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1013
Practice Address - Country:US
Practice Address - Phone:323-854-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130569106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty