Provider Demographics
NPI:1396233003
Name:HERNANDEZ, JUANA ESMERALDA (LMFT144751/APCC10339)
Entity type:Individual
Prefix:
First Name:JUANA
Middle Name:ESMERALDA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LMFT144751/APCC10339
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 BIRCH ST STE 112
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2255
Mailing Address - Country:US
Mailing Address - Phone:949-209-8444
Mailing Address - Fax:
Practice Address - Street 1:4000 BIRCH ST STE 112
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2255
Practice Address - Country:US
Practice Address - Phone:949-209-8444
Practice Address - Fax:949-209-8444
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT144751101YM0800X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)