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NPI Code Detail

MEDICARE: GENESIS NICOLE HERNANDEZ

MEDICARE: GENESIS NICOLE HERNANDEZ
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
1225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1588410245
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENESIS NICOLE HERNANDEZ
Provider Business Mailing Address
First Line : 1260 MORENA BLVD STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3850
Country : US
Telephone Number : 619-398-0355
Fax Number :
Provider Business Practice Location Address
First Line : 1260 MORENA BLVD STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3850
Country : US
Telephone Number : 619-398-0355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2024
Last Update Date : 05/27/2026

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Directions to “ GENESIS NICOLE HERNANDEZ ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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