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NPI Code Detail

MEDICARE: ILYANNE HERNANDEZ

MEDICARE: ILYANNE HERNANDEZ
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
1225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1730546185
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILYANNE HERNANDEZ
Provider Business Mailing Address
First Line : 1333 WILLOW PASS RD STE 200
Second Line :
City : CONCORD
State : CA
Zip : 94520-7923
Country : US
Telephone Number : 925-338-7928
Fax Number :
Provider Business Practice Location Address
First Line : 5776 STONERIDGE MALL RD STE 340
Second Line :
City : PLEASANTON
State : CA
Zip : 94588-4514
Country : US
Telephone Number : 925-223-8047
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2016
Last Update Date : 09/04/2025

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Directions to “ ILYANNE HERNANDEZ ” Practice Location

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