Provider Demographics
NPI:1013658525
Name:HERNANDEZ, STEVEN JOSEPH (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JOSEPH
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83397 SAN ASIS DR
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-5532
Mailing Address - Country:US
Mailing Address - Phone:760-238-2326
Mailing Address - Fax:
Practice Address - Street 1:47111 MONROE ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-6799
Practice Address - Country:US
Practice Address - Phone:760-775-8111
Practice Address - Fax:760-775-8064
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020280363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty