Healthcare Provider Details

I. General information

NPI: 1780578468
Provider Name (Legal Business Name): DAISY ISABEL HERNANDEZ-BADAJOZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAISY ISABEL HERNANDEZ

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E 28TH ST STE 319B
LONG BEACH CA
90806-2759
US

IV. Provider business mailing address

701 E 28TH ST STE 319B
LONG BEACH CA
90806-2759
US

V. Phone/Fax

Practice location:
  • Phone: 562-426-3656
  • Fax: 562-424-9990
Mailing address:
  • Phone: 562-426-3656
  • Fax: 562-424-9990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95035462
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: