Healthcare Provider Details

I. General information

NPI: 1831619808
Provider Name (Legal Business Name): GRISELDA HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 CAMINO DEL SOL
OXNARD CA
93030-3725
US

IV. Provider business mailing address

2200 OUTLET CENTER DR STE 430
OXNARD CA
93036-0611
US

V. Phone/Fax

Practice location:
  • Phone: 805-604-6437
  • Fax:
Mailing address:
  • Phone: 805-796-3619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: