Healthcare Provider Details

I. General information

NPI: 1497554331
Provider Name (Legal Business Name): LESLIE JOCELYN HERNANDEZ GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 WILSON AVE
YUBA CITY CA
95991-5925
US

IV. Provider business mailing address

26 MONTANA DR
OLIVEHURST CA
95961-7409
US

V. Phone/Fax

Practice location:
  • Phone: 530-821-8854
  • Fax:
Mailing address:
  • Phone: 530-599-2648
  • 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 State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: