Provider Demographics
NPI:1124512074
Name:HERNANDEZ ALVAREZ, NAYLEA JAFET
Entity type:Individual
Prefix:
First Name:NAYLEA
Middle Name:JAFET
Last Name:HERNANDEZ ALVAREZ
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 1:4701 E CESAR E CHAVEZ AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-1209
Mailing Address - Country:US
Mailing Address - Phone:323-267-3432
Mailing Address - Fax:
Practice Address - Street 1:4701 E CESAR E CHAVEZ AVE FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1209
Practice Address - Country:US
Practice Address - Phone:323-267-3400
Practice Address - Fax:323-260-5801
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
CA109760101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program