Healthcare Provider Details

I. General information

NPI: 1588578488
Provider Name (Legal Business Name): BRIANA DENISSE RODRIGUEZ HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 PARKCENTER DR STE 115
SANTA ANA CA
92705-3521
US

IV. Provider business mailing address

6152 STANTON AVE APT E211
BUENA PARK CA
90621-5413
US

V. Phone/Fax

Practice location:
  • Phone: 714-310-4377
  • Fax:
Mailing address:
  • Phone: 657-761-1173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: