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1003536384
MARK ANTHONY HERNANDEZ
FAIRFIELD, CA
NPI
1003536384
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-08-29
Last Update Date
2022-08-29
Business Address
MARK ANTHONY HERNANDEZ
1143 MISSOURI ST
FAIRFIELD, CA 94533-6007
Phone number: 707-435-9911
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Mailing Address
MARK ANTHONY HERNANDEZ
1143 MISSOURI ST
FAIRFIELD, CA 94533-6007
Phone number:
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