Provider Demographics
NPI:1467118687
Name:HERNANDEZ LOERA, ITZEL DANNAE (NP)
Entity Type:Individual
Prefix:
First Name:ITZEL
Middle Name:DANNAE
Last Name:HERNANDEZ LOERA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ITZEL
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6280 CHERRY AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-3254
Mailing Address - Country:US
Mailing Address - Phone:562-726-9073
Mailing Address - Fax:
Practice Address - Street 1:2801 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1701
Practice Address - Country:US
Practice Address - Phone:562-933-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019135363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care