(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003536384
Provider Name: MARK ANTHONY HERNANDEZ
Entity Type: Individual
Taxonomy Code: 101YA0400X
Specialty: Counselor
License Number:
Most Important Dates
Enumeration Date: 08/29/2022
Last Updated: 08/29/2022
Provider Practice Location
1143 MISSOURI ST
FAIRFIELD
CA
945336007
Practice Location Phone/Fax
Phone: 7074359911
Fax:
Provider Mailing Location
1143 MISSOURI ST
FAIRFIELD
CA
945336007
Provider Mailing Phone/Fax
Phone:
Fax: