Healthcare Provider Details

I. General information

NPI: 1245667351
Provider Name (Legal Business Name): WILLIAM L HERNANDEZ MSN, PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2013
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 N SUNRISE WAY
PALM SPRINGS CA
92262-3701
US

IV. Provider business mailing address

1695 N SUNRISE WAY
PALM SPRINGS CA
92262-3701
US

V. Phone/Fax

Practice location:
  • Phone: 760-323-2118
  • Fax:
Mailing address:
  • Phone: 760-323-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number23599
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number23599
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: