Provider Demographics
NPI:1841017514
Name:HERNANDEZ-FERRER, VIVIANA (PT)
Entity type:Individual
Prefix:DR
First Name:VIVIANA
Middle Name:
Last Name:HERNANDEZ-FERRER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 DABNER ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-1474
Mailing Address - Country:US
Mailing Address - Phone:510-812-3551
Mailing Address - Fax:
Practice Address - Street 1:122 DABNER ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-1474
Practice Address - Country:US
Practice Address - Phone:510-812-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36014261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy