Provider Demographics
NPI:1891193959
Name:HERNANDEZ, ALMA (CMT)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12981 PERRIS BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-4102
Mailing Address - Country:US
Mailing Address - Phone:951-485-6300
Mailing Address - Fax:951-485-6322
Practice Address - Street 1:12981 PERRIS BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-4102
Practice Address - Country:US
Practice Address - Phone:951-485-6300
Practice Address - Fax:951-485-6322
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1201225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist