Healthcare Provider Details

I. General information

NPI: 1861313652
Provider Name (Legal Business Name): GABRIELA L HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11731 TELEGRAPH RD STE K
SANTA FE SPRINGS CA
90670-6815
US

IV. Provider business mailing address

4707 PINAFORE ST APT 9
LOS ANGELES CA
90008-2125
US

V. Phone/Fax

Practice location:
  • Phone: 562-907-7429
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: