Healthcare Provider Details

I. General information

NPI: 1801775663
Provider Name (Legal Business Name): EVERLINDA HERNANDEZ BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 E SAN JOSE AVE
CLAREMONT CA
91711-5548
US

IV. Provider business mailing address

187 E SAN JOSE AVE
CLAREMONT CA
91711-5548
US

V. Phone/Fax

Practice location:
  • Phone: 909-210-6672
  • Fax:
Mailing address:
  • Phone: 909-210-6672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95038204
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberPHN566876
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95277193
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: