MEDICARE: NESTOR DANIEL HERMOSILLO

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
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1619802550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NESTOR DANIEL HERMOSILLO

Provider Business Mailing Address
First Line	:	1831 N GREENGROVE ST
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92865-4618
Country	:	US
Telephone Number	:	562-206-4178
Fax Number	:

Provider Business Practice Location Address
First Line	:	3281 E GUASTI RD STE 600
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91761-7611
Country	:	US
Telephone Number	:	909-323-7100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2026
Last Update Date	:	06/13/2026

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