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General NPI Number Information
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NPI Number | 1811766363
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Entity Type | Individual
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Provider Name | DAVINA MARIE HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 12/26/2023
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 49713 GORMAN POST RD
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City | GORMAN
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State | CA
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Zip | 93243-9701
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Country | US
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Telephone | 661-724-0001
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Fax | 661-481-3392
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Provider Business Mailing Address
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Address Line | 49713 GORMAN POST RD
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City | GORMAN
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State | CA
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Zip | 93243-9701
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Country | US
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Telephone | 661-724-0001
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Fax | 661-481-3392
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | NA
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License Number State |
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