Provider Demographics
NPI:1972347714
Name:HERNANDEZ-GATO, IDANIA D (PSYD, MBA)
Entity type:Individual
Prefix:MS
First Name:IDANIA
Middle Name:D
Last Name:HERNANDEZ-GATO
Suffix:
Gender:F
Credentials:PSYD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 SUNRAY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4643
Mailing Address - Country:US
Mailing Address - Phone:787-503-3872
Mailing Address - Fax:
Practice Address - Street 1:17820 MOUND RD STE B
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-4903
Practice Address - Country:US
Practice Address - Phone:651-505-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist