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General NPI Number Information
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NPI Number | 1972227098
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Entity Type | Individual
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Provider Name | JESSICA HERNANDEZ FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 11/28/2024
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Provider Practice Location Address
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Address Line | 14445 OLIVE VIEW DR
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City | SYLMAR
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State | CA
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Zip | 91342-1437
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Country | US
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Telephone | 747-210-4186
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Fax |
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Provider Business Mailing Address
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Address Line | 3113 W CHANDLER BLVD
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City | BURBANK
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State | CA
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Zip | 91505-2646
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Country | US
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Telephone | 818-823-7587
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95021248
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License Number State | CA
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