Provider Demographics
NPI:1174910731
Name:HERNANDEZ, AIDA ESTHER (MA)
Entity type:Individual
Prefix:MRS
First Name:AIDA
Middle Name:ESTHER
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 MONMOUTH RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1561
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:220 MONMOUTH RD
Practice Address - Street 2:SUITE 7
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1561
Practice Address - Country:US
Practice Address - Phone:732-962-6892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00545100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional