MEDICARE: ALEJANDRA HERNANDEZ BS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	FCDJEU	CA
2	172V00000X	Community Health Worker
3	104100000X	Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326790338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRA HERNANDEZ BS

Provider Business Mailing Address
First Line	:	7899 MISSION GROVE PKWY S
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-5056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7899 MISSION GROVE PKWY S
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-5088
Country	:	US
Telephone Number	:	951-776-9223
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2022
Last Update Date	:	08/03/2024

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