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NPI Code Detail

MEDICARE: GERARDO HERNANDEZ RN

MEDICARE: GERARDO HERNANDEZ RN
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
1163W00000XRegistered Nurse95315308CA

General Provider Information

NPI Number : 1649109257
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERARDO HERNANDEZ RN
Provider Business Mailing Address
First Line : 1800 N CALIFORNIA ST
Second Line :
City : STOCKTON
State : CA
Zip : 95204-6019
Country : US
Telephone Number : 209-943-2000
Fax Number :
Provider Business Practice Location Address
First Line : 1800 N CALIFORNIA ST
Second Line :
City : STOCKTON
State : CA
Zip : 95204-6019
Country : US
Telephone Number : 209-943-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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Directions to “ GERARDO HERNANDEZ RN” Practice Location

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