Provider Demographics
NPI:1063923431
Name:HERNANDEZ, MARITZA G
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:G
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 HAYES ST APT C
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3660
Mailing Address - Country:US
Mailing Address - Phone:831-776-3557
Mailing Address - Fax:
Practice Address - Street 1:60 W MARKET ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2655
Practice Address - Country:US
Practice Address - Phone:831-758-0181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor