Provider Demographics
NPI:1548802192
Name:HERNANDEZ PEREZ, DOLORES ALICIA II (RADT1)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:ALICIA
Last Name:HERNANDEZ PEREZ
Suffix:II
Gender:
Credentials:RADT1
Other - Prefix:MRS
Other - First Name:DOLORES
Other - Middle Name:ALICIA
Other - Last Name:HERENANDEZ PEREZ
Other - Suffix:II
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8755 AERO DR STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1750
Mailing Address - Country:US
Mailing Address - Phone:858-256-2180
Mailing Address - Fax:
Practice Address - Street 1:8755 AERO DR STE 230
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1750
Practice Address - Country:US
Practice Address - Phone:858-256-2180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty