Healthcare Provider Details

I. General information

NPI: 1700776259
Provider Name (Legal Business Name): MONICA HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7250 WIEST RD
CALIPATRIA CA
92233-9604
US

IV. Provider business mailing address

360 J ST
BRAWLEY CA
92227-2538
US

V. Phone/Fax

Practice location:
  • Phone: 760-399-4992
  • Fax: 760-457-2645
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: