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General NPI Number Information
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NPI Number | 1871717629
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Entity Type | Individual
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Provider Name | ANNA MARIE HERNANDEZ RPT
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 8265 WHITE OAK AVENUE HORIZON THERAPY
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730
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Country | US
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Telephone | 909-373-1641
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Fax | 909-373-0444
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Provider Business Mailing Address
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Address Line | 17100 BEAR VALLEY RD
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City | VICTORVILLE
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State | CA
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Zip | 92395-8320
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Country | US
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Telephone | 442-242-4844
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 11332
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License Number State | CA
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