Healthcare Provider Details

I. General information

NPI: 1154243913
Provider Name (Legal Business Name): JOSEPHINE KAY HERNANDEZ MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26520 CACTUS AVE
MORENO VALLEY CA
92555-3927
US

IV. Provider business mailing address

5606 DARIEN CT
RIVERSIDE CA
92505-2315
US

V. Phone/Fax

Practice location:
  • Phone: 951-486-4247
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14429595
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41440
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: