Healthcare Provider Details

I. General information

NPI: 1659820165
Provider Name (Legal Business Name): VANESSA ZAYONARA HERNANDEZ B.A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2016
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 N BROADWAY
ESCONDIDO CA
92026-3043
US

IV. Provider business mailing address

1029 N BROADWAY
ESCONDIDO CA
92026-3043
US

V. Phone/Fax

Practice location:
  • Phone: 760-489-4126
  • Fax:
Mailing address:
  • Phone: 760-685-1564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: