Provider Demographics
NPI:1013692631
Name:HERNANDEZ NAVARRO, BEVERLY KARINA
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:KARINA
Last Name:HERNANDEZ NAVARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15003 DOMART AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-5305
Mailing Address - Country:US
Mailing Address - Phone:562-528-4483
Mailing Address - Fax:
Practice Address - Street 1:6119 AGRA ST
Practice Address - Street 2:
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201-1705
Practice Address - Country:US
Practice Address - Phone:562-776-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA63777363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant