Provider Demographics
NPI:1447015003
Name:AMOR FAMILY THERAPY PROF CORP
Entity type:Organization
Organization Name:AMOR FAMILY THERAPY PROF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JURIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:661-505-0680
Mailing Address - Street 1:23550 LYONS AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-5745
Mailing Address - Country:US
Mailing Address - Phone:661-230-6267
Mailing Address - Fax:
Practice Address - Street 1:23550 LYONS AVE STE 211
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-5745
Practice Address - Country:US
Practice Address - Phone:661-230-6267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health