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NPI Code Detail

MEDICARE: SANDY HERNANDEZ BCBA

MEDICARE: SANDY HERNANDEZ BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-13-14689CA

General Provider Information

NPI Number : 1154750537
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDY HERNANDEZ BCBA
Provider Business Mailing Address
First Line : 6713 IRON HORSE LN
Second Line :
City : EASTVALE
State : CA
Zip : 92880-9128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2155 CHICAGO AVE STE 203
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-2209
Country : US
Telephone Number : 310-493-2228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2013
Last Update Date : 10/10/2016

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Directions to “ SANDY HERNANDEZ BCBA” Practice Location

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