Healthcare Provider Details

I. General information

NPI: 1386489433
Provider Name (Legal Business Name): ANNA CHRISTINA HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2024
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 DRAPER ST
KINGSBURG CA
93631-1934
US

IV. Provider business mailing address

3875 W BEECHWOOD AVE
FRESNO CA
93711-0794
US

V. Phone/Fax

Practice location:
  • Phone: 800-492-4227
  • Fax:
Mailing address:
  • Phone: 800-492-4227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number138881
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: