Provider Demographics
NPI:1972362606
Name:HERNANDEZ-PEREZ, CLARISSA ROSE (RN)
Entity Type:Individual
Prefix:
First Name:CLARISSA
Middle Name:ROSE
Last Name:HERNANDEZ-PEREZ
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 1:2100 JAY AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3921
Mailing Address - Country:US
Mailing Address - Phone:956-331-5955
Mailing Address - Fax:
Practice Address - Street 1:619 LEAFY RDG
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4251
Practice Address - Country:US
Practice Address - Phone:956-331-5955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator