Healthcare Provider Details

I. General information

NPI: 1497664916
Provider Name (Legal Business Name): RICARDO HERNANDEZ JR. PPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 4TH STREET 440 PLUMAS AVE
OROVILLE CA
95965
US

IV. Provider business mailing address

2045 4TH STREET
OROVILLE CA
95965
US

V. Phone/Fax

Practice location:
  • Phone: 530-538-8822
  • Fax:
Mailing address:
  • Phone: 530-538-8822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: