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General NPI Number Information
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NPI Number | 1407579113
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Entity Type | Individual
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Provider Name | LUDYVINA HERNANDEZ DOCTORAL CANDIDATE
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Gender | Female
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 2400 E KATELLA AVE
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City | ANAHEIM
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State | CA
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Zip | 92806-5945
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Country | US
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Telephone | 714-922-9600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8101
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93403-8101
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Country | US
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Telephone | 805-547-7900
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CA
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