MEDICARE: AMY E BONTEMPO-HERNANDEZ FNP

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	363LF0000X	Family Nurse Practitioner	NP95017169	CA

General Provider Information

NPI Number	:	1700450566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY E BONTEMPO-HERNANDEZ FNP

Provider Business Mailing Address
First Line	:	22388 MIDTOWN CT
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91350-5741
Country	:	US
Telephone Number	:	661-755-9488
Fax Number	:

Provider Business Practice Location Address
First Line	:	19042 SOLEDAD CANYON RD
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91351-3362
Country	:	US
Telephone Number	:	661-367-8429
Fax Number	:

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

Provider Enumeration Date	:	05/17/2021
Last Update Date	:	07/21/2023

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