Healthcare Provider Details

I. General information

NPI: 1013487008
Provider Name (Legal Business Name): KARINA HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2018
Last Update Date: 02/11/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 W ORANGEWOOD AVE STE 110
ORANGE CA
92868-5056
US

IV. Provider business mailing address

206 N JACKSON ST STE 202
GLENDALE CA
91206-4330
US

V. Phone/Fax

Practice location:
  • Phone: 714-696-2862
  • Fax: 714-242-9308
Mailing address:
  • Phone: 818-241-6780
  • Fax: 818-241-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-78164
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: