Healthcare Provider Details

I. General information

NPI: 1003638198
Provider Name (Legal Business Name): MAIYING HER CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2933 UNIVERSITY AVE
RIVERSIDE CA
92507-4243
US

IV. Provider business mailing address

11925 ELMROCK AVE
WHITTIER CA
90604-3724
US

V. Phone/Fax

Practice location:
  • Phone: 951-224-8220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number95030710
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: