Provider Demographics
NPI:1093235178
Name:HERNANDEZ, KASI (LMFT)
Entity type:Individual
Prefix:
First Name:KASI
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 OLD BAYSHORE HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-1616
Mailing Address - Country:US
Mailing Address - Phone:408-542-0399
Mailing Address - Fax:
Practice Address - Street 1:1575 OLD BAYSHORE HWY STE 201
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1616
Practice Address - Country:US
Practice Address - Phone:408-542-0399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101670106H00000X
CA151102106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist