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General NPI Number Information
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NPI Number | 1396094231
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Entity Type | Individual
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Provider Name | EMILY HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 10200 LEHIGH AVE
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City | MONTCLAIR
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State | CA
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Zip | 91763
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Country | US
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Telephone | 909-445-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 645 W. CARTER ST
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City | RIALTO
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State | CA
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Zip | 92376
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Country | US
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Telephone |
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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 | 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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