Healthcare Provider Details

I. General information

NPI: 1063463727
Provider Name (Legal Business Name): PAMELA HERNANDEZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 11TH ST
REEDLEY CA
93654-2926
US

IV. Provider business mailing address

1479 W LACEY BLVD
HANFORD CA
93230-5906
US

V. Phone/Fax

Practice location:
  • Phone: 559-638-3227
  • Fax: 559-638-3799
Mailing address:
  • Phone: 559-583-4617
  • Fax: 559-583-4625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA15761
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: