Provider Demographics
NPI:1477820538
Name:HERNANDEZ, MARTHA PATRICIA
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:PATRICIA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 S C ST STE C
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-4573
Mailing Address - Country:US
Mailing Address - Phone:805-385-9420
Mailing Address - Fax:
Practice Address - Street 1:2500 S C ST STE C
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-4573
Practice Address - Country:US
Practice Address - Phone:805-385-9420
Practice Address - Fax:805-385-9401
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator