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NPI Code Detail

MEDICARE: JACQUELINE HERNANDEZ PA

MEDICARE: JACQUELINE HERNANDEZ PA
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
1363A00000XPhysician AssistantPA67812CA

General Provider Information

NPI Number : 1528839222
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE HERNANDEZ PA
Provider Business Mailing Address
First Line : 5511 CRYSTAL CASCADE LN
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93313-4874
Country : US
Telephone Number : 661-817-5159
Fax Number :
Provider Business Practice Location Address
First Line : 705 GRAND AVE
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-2639
Country : US
Telephone Number : 805-544-2478
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2024
Last Update Date : 04/01/2026

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Directions to “ JACQUELINE HERNANDEZ PA” Practice Location

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