Provider Demographics
NPI:1316291404
Name:HERNANDEZ, LAURA (LMFT 152562)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LMFT 152562
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4442
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93140-4442
Mailing Address - Country:US
Mailing Address - Phone:805-636-6656
Mailing Address - Fax:
Practice Address - Street 1:602 ANACAPA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1615
Practice Address - Country:US
Practice Address - Phone:805-964-8857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA152562106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist