Provider Demographics
NPI:1730252511
Name:HERNANDEZ, SIMONE G (MA, PPS SCHOOL PSYCH)
Entity type:Individual
Prefix:MRS
First Name:SIMONE
Middle Name:G
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MA, PPS SCHOOL PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 LISA LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3902
Mailing Address - Country:US
Mailing Address - Phone:925-682-8000
Mailing Address - Fax:925-682-4561
Practice Address - Street 1:2400 LISA LN
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3902
Practice Address - Country:US
Practice Address - Phone:925-682-8000
Practice Address - Fax:925-682-4561
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No171M00000XOther Service ProvidersCase Manager/Care Coordinator