Provider Demographics
NPI:1285471466
Name:HERNANDEZ, ERICKSON ASHTON
Entity type:Individual
Prefix:
First Name:ERICKSON
Middle Name:ASHTON
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13925 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-4241
Mailing Address - Country:US
Mailing Address - Phone:714-605-3538
Mailing Address - Fax:
Practice Address - Street 1:13925 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-4241
Practice Address - Country:US
Practice Address - Phone:714-605-3538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health