Provider Demographics
NPI:1780578468
Name:HERNANDEZ-BADAJOZ, DAISY ISABEL
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:ISABEL
Last Name:HERNANDEZ-BADAJOZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAISY
Other - Middle Name:ISABEL
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 E 28TH ST STE 319B
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2759
Mailing Address - Country:US
Mailing Address - Phone:562-426-3656
Mailing Address - Fax:562-424-9990
Practice Address - Street 1:701 E 28TH ST STE 319B
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2759
Practice Address - Country:US
Practice Address - Phone:562-426-3656
Practice Address - Fax:562-424-9990
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035462363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner