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General NPI Number Information
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NPI Number | 1134996853
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Entity Type | Individual
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Provider Name | MR. JOSEPH JONATHAN HERNANDEZ
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Gender | Male
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 2719 N AIR FRESNO DR
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City | FRESNO
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State | CA
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Zip | 93727-1547
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Country | US
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Telephone | 559-600-9180
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Fax |
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Provider Business Mailing Address
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Address Line | 1149 W BEDFORD AVE
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City | FRESNO
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State | CA
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Zip | 93711-0708
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Country | US
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Telephone | 559-862-6063
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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