Healthcare Provider Details

I. General information

NPI: 1932493699
Provider Name (Legal Business Name): ERWIN CERENO HERNANDEZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2011
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17074 DEVONSHIRE ST
NORTHRIDGE CA
91325-1617
US

IV. Provider business mailing address

401 E CARRILLO ST
SANTA BARBARA CA
93101-1460
US

V. Phone/Fax

Practice location:
  • Phone: 818-428-1790
  • Fax: 888-801-0607
Mailing address:
  • Phone: 805-563-3307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA21379
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: