Healthcare Provider Details

I. General information

NPI: 1326962671
Provider Name (Legal Business Name): LORENA HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 COLLEGE DR
SAN JOSE CA
95128-3610
US

IV. Provider business mailing address

932 COLLEGE DR
SAN JOSE CA
95128-3610
US

V. Phone/Fax

Practice location:
  • Phone: 714-618-7648
  • Fax:
Mailing address:
  • Phone: 714-618-7648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95022265
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: