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General NPI Number Information
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NPI Number | 1811807613
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Entity Type | Individual
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Provider Name | GEORGETTE HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 17508 HERCULES ST. SUITE B6
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City | HESPERIA
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State | CA
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Zip | 92345
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Country | US
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Telephone | 760-488-7971
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Fax | 760-230-9183
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Provider Business Mailing Address
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Address Line | PO BOX 401096
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City | HESPERIA
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State | CA
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Zip | 92340-1096
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Country | US
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Telephone | 760-488-7971
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Fax | 760-230-9183
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | CA
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