Provider Demographics
NPI:1679899819
Name:HERNANDEZ, NOEL BUENAFE (RPT)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:BUENAFE
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 S SUNNYVALE AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-6287
Mailing Address - Country:US
Mailing Address - Phone:408-616-8880
Mailing Address - Fax:408-616-8885
Practice Address - Street 1:260 S SUNNYVALE AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6287
Practice Address - Country:US
Practice Address - Phone:408-616-8880
Practice Address - Fax:408-616-8885
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22508174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist