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1558842567
MIGUEL HERNANDEZ
SANTA MONICA, CA
NPI
1558842567
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1226930416)
Enumeration Date
2018-08-27
Last Update Date
2018-08-27
Business Address
MIGUEL HERNANDEZ R1226930416
907 PICO BLVD
SANTA MONICA, CA 90405-1326
Phone number: 310-314-6200
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Mailing Address
MIGUEL HERNANDEZ R1226930416
514 W ARBOR VITAE ST APT 2
INGLEWOOD, CA 90301-3155
Phone number: 310-251-2441
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