Provider Demographics
NPI:1841961836
Name:HERNANDEZ RODRIGUEZ, LEIDY (LCSW)
Entity type:Individual
Prefix:
First Name:LEIDY
Middle Name:
Last Name:HERNANDEZ RODRIGUEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1986 GLADSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-7275
Mailing Address - Country:US
Mailing Address - Phone:831-585-6009
Mailing Address - Fax:
Practice Address - Street 1:1986 GLADSTONE WAY
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-7275
Practice Address - Country:US
Practice Address - Phone:831-585-6009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA890921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical