Healthcare Provider Details

I. General information

NPI: 1720997364
Provider Name (Legal Business Name): ALEJANDRO HERNANDEZ CMTC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68850 JARANA RD
CATHEDRAL CITY CA
92234-3718
US

IV. Provider business mailing address

68850 JARANA RD
CATHEDRAL CITY CA
92234-3718
US

V. Phone/Fax

Practice location:
  • Phone: 760-333-5081
  • Fax: 760-333-5081
Mailing address:
  • Phone: 760-333-5081
  • Fax: 760-333-5081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: