Healthcare Provider Details

I. General information

NPI: 1225860240
Provider Name (Legal Business Name): BRIANA MARIE HERNANDEZ AITKEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRIANA MARIE HERNANDEZ

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 E. RAMONA EXPRESSWAY, SUITE 1-3
PERRIS CA
92571
US

IV. Provider business mailing address

85 E. RAMONA EXPRESSWAY, SUITE 1-3
PERRIS CA
92571
US

V. Phone/Fax

Practice location:
  • Phone: 951-349-4195
  • Fax:
Mailing address:
  • Phone: 951-349-4195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: