Provider Demographics
NPI:1962040998
Name:HERNANDEZ, MARGARITA (DPT)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 FARMERS LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-6765
Mailing Address - Country:US
Mailing Address - Phone:707-578-7176
Mailing Address - Fax:707-578-4220
Practice Address - Street 1:1221 FARMERS LN STE B
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-6712
Practice Address - Country:US
Practice Address - Phone:707-578-7176
Practice Address - Fax:707-578-4220
Is Sole Proprietor?:No
Enumeration Date:2019-12-20
Last Update Date:2025-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT294429225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT294429OtherPT LICENCE