Healthcare Provider Details

I. General information

NPI: 1639192453
Provider Name (Legal Business Name): TESSIE ERINN HERNANDEZ RN, MSN, PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W CALIFORNIA BLVD
PASADENA CA
91105-3010
US

IV. Provider business mailing address

1143 PALM TER
PASADENA CA
91104-3713
US

V. Phone/Fax

Practice location:
  • Phone: 626-397-3179
  • Fax:
Mailing address:
  • Phone: 323-697-4940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number488157
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number13006
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number488157
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: