Healthcare Provider Details
I. General information
NPI: 1477343309
Provider Name (Legal Business Name): AERISLEEP MOBILE DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5720 WILLARD WAY
RIVERSIDE CA
92504-1529
US
IV. Provider business mailing address
5720 WILLARD WAY
RIVERSIDE CA
92504-1529
US
V. Phone/Fax
- Phone: 909-242-1199
- Fax:
- Phone: 909-242-1199
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225B00000X |
| Taxonomy | Pulmonary Function Technologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335V00000X |
| Taxonomy | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YESENIA
HERNANDEZ
Title or Position: OWNER
Credential: RCP
Phone: 909-242-1199