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NPI Code Detail

MEDICARE: MA DOLORES HERNANDEZ

MEDICARE: MA DOLORES 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
13747A0650XAttendant Care Provider

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1D5689720OTHERCADRIVER LICENSE

General Provider Information

NPI Number : 1952914467
Entity Type Code : Individual
Provider Name (Legal Business Name) : MA DOLORES HERNANDEZ
Provider Business Mailing Address
First Line : 13549 ELSWORTH ST
Second Line :
City : MORENO VALLEY
State : CA
Zip : 92553-8463
Country : US
Telephone Number : 951-229-1129
Fax Number :
Provider Business Practice Location Address
First Line : 1001 S HALE AVE SPC 54
Second Line :
City : ESCONDIDO
State : CA
Zip : 92029-2177
Country : US
Telephone Number : 760-729-8295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2020
Last Update Date : 08/25/2020

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1881226454 — CHRISTINA HELEN RAMIREZ-CORZA
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1952910705 — MILLICENT GABRIELLE MOORE
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1356958151 — AMELIA DIAZ
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Directions to “ MA DOLORES HERNANDEZ ” Practice Location

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