Healthcare Provider Details

I. General information

NPI: 1891626065
Provider Name (Legal Business Name): GABRIELA HERNANDEZ PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3134 PACIFIC AVE
STOCKTON CA
95204-3640
US

IV. Provider business mailing address

1239 W MONTEREY AVE
STOCKTON CA
95204-3034
US

V. Phone/Fax

Practice location:
  • Phone: 209-910-3383
  • Fax:
Mailing address:
  • Phone: 209-356-8799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number94027880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: