Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-62 | CA |
NPI | 1003930918 |
---|---|
Provider Name | Dr. Connie Sutherland Hernandez |
First Address | Palo Alto, CA 94306-4034 |
Second Address | Palo Alto, CA 94306-4034 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2007 |
Last Update Date | 08/07/2007 |