| Laura M Hernandez Licensed Clinical Social Worker Apc | |
|
611 Wilshire Blvd Ste 900 Los Angeles CA 90017-2905 | |
| (626) 344-9742 | |
| Not Available |
| Full Name | Laura M Hernandez Licensed Clinical Social Worker Apc |
|---|---|
| Speciality | Social Worker |
| Location | 611 Wilshire Blvd Ste 900, Los Angeles, California |
| Authorized Official Name and Position | Laura Michelle Hernandez (CEO) |
| Authorized Official Contact | 6263449742 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laura M Hernandez Licensed Clinical Social Worker Apc 3680 Wilshire Blvd Ste P041096 Los Angeles CA 90010-2707 Ph: (626) 344-9742 | Laura M Hernandez Licensed Clinical Social Worker Apc 611 Wilshire Blvd Ste 900 Los Angeles CA 90017-2905 Ph: (626) 344-9742 |
| NPI Number | 1134983679 |
|---|---|
| Provider Enumeration Date | 02/06/2024 |
| Last Update Date | 02/21/2024 |
| Certification Date | 02/21/2024 |
| Medicare PECOS PAC ID | 7719324367 |
|---|---|
| Medicare Enrollment ID | O20240319002471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134983679 | NPI | - | NPPES |
| 1992475594 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Laura Michelle Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992475594 PECOS PAC ID: 8628415270 Enrollment ID: I20240319002523 |
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