Provider Demographics
NPI:1215442199
Name:HERNANDEZ, ARIELLE MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:MARIE
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 1:3380 LA SIERRA AVE STE 104-723
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-5271
Mailing Address - Country:US
Mailing Address - Phone:951-403-9622
Mailing Address - Fax:
Practice Address - Street 1:5033 ARLINGTON AVE STE A
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-2727
Practice Address - Country:US
Practice Address - Phone:951-403-9622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103758106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist