Provider Demographics
NPI:1043926462
Name:HERNANDEZ, YESENIA (RCP)
Entity Type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 WILLARD WAY
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-1529
Mailing Address - Country:US
Mailing Address - Phone:909-242-1199
Mailing Address - Fax:
Practice Address - Street 1:5720 WILLARD WAY
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-1529
Practice Address - Country:US
Practice Address - Phone:909-242-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRC37332278H0200X
CA364952278H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome HealthGroup - Multi-Specialty