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General NPI Number Information
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NPI Number | 1093662322
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Entity Type | Individual
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Provider Name | MICHELLE HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 25322 LONE ACRES RD
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City | MENIFEE
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State | CA
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Zip | 92584-9637
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Country | US
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Telephone | 951-230-1316
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Fax |
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Provider Business Mailing Address
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Address Line | 25322 LONE ACRES RD
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City | MENIFEE
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State | CA
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Zip | 92584-9637
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Country | US
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Telephone | 951-230-1316
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | LEP4734
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License Number State | CA
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