1528646122 NPI number — DR. VIRGINIA RONDERO HERNANDEZ ACC, NBC-HWC, LCSW

Table of content: DR. VIRGINIA RONDERO HERNANDEZ ACC, NBC-HWC, LCSW (NPI 1528646122)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528646122 NPI number — DR. VIRGINIA RONDERO HERNANDEZ ACC, NBC-HWC, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERNANDEZ
Provider First Name:
VIRGINIA
Provider Middle Name:
RONDERO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ACC, NBC-HWC, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RONDERO HERNANDEZ
Provider Other First Name:
VIRGINIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ACC, NBC-HWC, LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1528646122
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1326 TAUBENFELD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78260-4459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-307-3740
Provider Business Mailing Address Fax Number:
559-472-3313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1326 TAUBENFELD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78260-4459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-307-3740
Provider Business Practice Location Address Fax Number:
559-472-3313
Provider Enumeration Date:
04/01/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  16449 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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