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General NPI Number Information
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NPI Number | 1548519010
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Entity Type | Individual
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Provider Name | ROCIO I HERNANDEZ FNP
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Gender | Female
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 2353 PACIFIC AVE STE A
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City | STOCKTON
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State | CA
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Zip | 95204-5309
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Country | US
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Telephone | 510-449-4257
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Fax |
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Provider Business Mailing Address
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Address Line | 4219 PINEHURST CIR
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City | STOCKTON
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State | CA
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Zip | 95219-1882
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Country | US
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Telephone | 510-449-4257
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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 | 95028091
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WX0002X
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Taxonomy Name | High-Risk Obstetric Registered Nurse
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License Number | 823343
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License Number State | CA
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