Healthcare Provider Details

I. General information

NPI: 1366126815
Provider Name (Legal Business Name): JENNIFER CHIHUAHUA-HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 WILLOW PASS RD STE 230
CONCORD CA
94520-7929
US

IV. Provider business mailing address

1430 WILLOW PASS RD STE 230
CONCORD CA
94520-7929
US

V. Phone/Fax

Practice location:
  • Phone: 925-288-3950
  • Fax:
Mailing address:
  • Phone: 925-288-3950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: