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General NPI Number Information
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NPI Number | 1023824034
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Entity Type | Individual
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Provider Name | FLOR BERENICE JUAREZ HERNANDEZ FNP
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Gender | Female
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 3505 LONE TREE WAY STE 1
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City | ANTIOCH
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State | CA
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Zip | 94509-6067
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Country | US
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Telephone | 925-457-4276
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Fax |
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Provider Business Mailing Address
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Address Line | 525 S 19TH ST
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City | RICHMOND
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State | CA
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Zip | 94804-3803
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Country | US
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Telephone | 510-837-7436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95030010
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License Number State | CA
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