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General NPI Number Information
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NPI Number | 1780561415
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Entity Type | Individual
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Provider Name | STEFFEN ENRIQUE HERNANDEZ
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Gender | Male
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 310 1/2 1ST ST
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City | MARYSVILLE
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State | CA
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Zip | 95901-6036
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Country | US
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Telephone | 530-763-5918
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Fax |
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Provider Business Mailing Address
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Address Line | 981 E SCHOOL WAY
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City | REDWOOD VALLEY
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State | CA
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Zip | 95470-6320
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Country | US
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Telephone | 707-472-8775
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | E208896
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License Number State | CA
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