Healthcare Provider Details

I. General information

NPI: 1316687866
Provider Name (Legal Business Name): MONICA MARIE HERNANDEZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MONICA MARIE BERNAL DO

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 09/07/2025
Certification Date: 09/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E 4TH ST FL 1
SANTA ANA CA
92705-3910
US

IV. Provider business mailing address

6082 BANNOCK RD
WESTMINSTER CA
92683-1922
US

V. Phone/Fax

Practice location:
  • Phone: 866-353-5060
  • Fax:
Mailing address:
  • Phone: 213-703-7629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A21481
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: