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NPI Code Detail

MEDICARE: MS. IRMA HERNANDEZ SOTO NP

MEDICARE:  MS. IRMA HERNANDEZ SOTO  NP
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
1163W00000XRegistered Nurse814787CA
2363LP0200XPediatric Nurse Practitioner95003989CA

General Provider Information

NPI Number : 1568818789
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. IRMA HERNANDEZ SOTO NP
Provider Business Mailing Address
First Line : 15443 OLD CASTLE RD
Second Line :
City : FONTANA
State : CA
Zip : 92337-0909
Country : US
Telephone Number : 909-275-0416
Fax Number :
Provider Business Practice Location Address
First Line : 11285 MOUNTAIN VIEW AVE
Second Line : 40
City : LOMA LINDA
State : CA
Zip : 92354-3862
Country : US
Telephone Number : 909-558-5844
Fax Number : 909-558-3168
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2016
Last Update Date : 12/22/2023

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