MEDICARE: ANNASTASIA 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
1	106S00000X	Behavior Technician	RBT25497340	CO

General Provider Information

NPI Number	:	1760338305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNASTASIA HERNANDEZ

Provider Business Mailing Address
First Line	:	3128 EAGLE BLVD APT I169
Second Line	:
City	:	BRIGHTON
State	:	CO
Zip	:	80601-7428
Country	:	US
Telephone Number	:	385-494-3500
Fax Number	:	385-494-3503

Provider Business Practice Location Address
First Line	:	3128 EAGLE BLVD APT I169
Second Line	:
City	:	BRIGHTON
State	:	CO
Zip	:	80601-7428
Country	:	US
Telephone Number	:	385-494-3500
Fax Number	:	385-494-3503

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

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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Directions to “ ANNASTASIA HERNANDEZ ” Practice Location

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