Provider Demographics
NPI:1609231273
Name:HERNANDEZ, CATALINA FLORA (RN)
Entity Type:Individual
Prefix:MS
First Name:CATALINA
Middle Name:FLORA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5472
Mailing Address - Country:US
Mailing Address - Phone:559-232-9371
Mailing Address - Fax:
Practice Address - Street 1:208 MAPLE ST
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5472
Practice Address - Country:US
Practice Address - Phone:559-232-9371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA754441163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse