Provider Demographics
NPI:1881735421
Name:HERNANDEZ, NATALIE EVE (LMFT)
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:EVE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22047 GOLDENCHAIN ST
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-6956
Mailing Address - Country:US
Mailing Address - Phone:951-653-3980
Mailing Address - Fax:
Practice Address - Street 1:1430 E COOLEY DR
Practice Address - Street 2:SUITE 111
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3934
Practice Address - Country:US
Practice Address - Phone:909-825-5128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43928106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist