Provider Demographics
NPI:1982588034
Name:HERNANDEZ, MONTSERRAT G
Entity type:Individual
Prefix:
First Name:MONTSERRAT
Middle Name:G
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 1:1633 E 4TH ST STE 156
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-5170
Mailing Address - Country:US
Mailing Address - Phone:949-731-5400
Mailing Address - Fax:
Practice Address - Street 1:1633 E 4TH ST STE 156
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-5170
Practice Address - Country:US
Practice Address - Phone:949-731-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1250101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical