Provider Demographics
NPI:1447930227
Name:HERNANDEZ, ALISON NICOLE
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:NICOLE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7661 DENIO WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-6613
Mailing Address - Country:US
Mailing Address - Phone:559-836-3680
Mailing Address - Fax:
Practice Address - Street 1:1130 CONROY LN STE 301
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4154
Practice Address - Country:US
Practice Address - Phone:916-542-9514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist