=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609727122
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELANIE M HERNANDEZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2026
-----------------------------------------------------
Last Update Date | 02/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 190 SIERRA CT STE B101
-----------------------------------------------------
City | PALMDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93550-7603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-666-0829
-----------------------------------------------------
Fax | --
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4838 W AVENUE L10 APT 9
-----------------------------------------------------
City | QUARTZ HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93536-4506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-666-0829
-----------------------------------------------------
Fax | --
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | Y9681680
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------