Healthcare Provider Details

I. General information

NPI: 1346179934
Provider Name (Legal Business Name): LILIANA HERNANDEZ PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16360 ROSCOE BLVD FL 2
VAN NUYS CA
91406-1219
US

IV. Provider business mailing address

8833 GUTHRIE AVE APT 10
LOS ANGELES CA
90034-7161
US

V. Phone/Fax

Practice location:
  • Phone: 818-908-4999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberY6188229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: