Healthcare Provider Details

I. General information

NPI: 1376300095
Provider Name (Legal Business Name): SAVANNAH HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23502 LYONS AVE STE 304A
SANTA CLARITA CA
91321-2538
US

IV. Provider business mailing address

23502 LYONS AVE STE 304A
SANTA CLARITA CA
91321-2538
US

V. Phone/Fax

Practice location:
  • Phone: 661-706-0166
  • Fax:
Mailing address:
  • Phone: 661-702-0166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: