MEDICARE: SANDRELYN CHUA HERNANDEZ RN, NP

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	163W00000X	Registered Nurse	95205284	CA
2	363L00000X	Nurse Practitioner	95022593	CA

General Provider Information

NPI Number	:	1952949851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRELYN CHUA HERNANDEZ RN, NP

Provider Business Mailing Address
First Line	:	3421 CALLE DEL SUR
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92009-8617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3421 CALLE DEL SUR
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92009
Country	:	US
Telephone Number	:	619-964-4406
Fax Number	:

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

Provider Enumeration Date	:	12/11/2019
Last Update Date	:	03/20/2026

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