Provider Demographics
NPI:1811393135
Name:HERNANDEZ, EMILY NICOLE (ND)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NICOLE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:NICOLE
Other - Last Name:POCCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NMD
Mailing Address - Street 1:7472 LA JOLLA BLVD SUITE A
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-255-8244
Mailing Address - Fax:858-255-8267
Practice Address - Street 1:7472 LA JOLLA BLVD SUITE A
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-255-8244
Practice Address - Fax:858-255-8267
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND678175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath