Provider Demographics
NPI:1679300222
Name:HERNANDEZ, LYN (NP)
Entity type:Individual
Prefix:
First Name:LYN
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 EUCLID AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950
Mailing Address - Country:US
Mailing Address - Phone:619-267-9257
Mailing Address - Fax:619-267-9273
Practice Address - Street 1:610 EUCLID AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950
Practice Address - Country:US
Practice Address - Phone:619-267-9257
Practice Address - Fax:619-267-9273
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016426363LF0000X, 363LP0808X
CANP95016426363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty