Provider Demographics
NPI:1952726226
Name:HERNANDEZ-DJABRAYAN, VERONICA (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:HERNANDEZ-DJABRAYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:HERNANDEZ-SOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6136 N SELLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-1553
Mailing Address - Country:US
Mailing Address - Phone:559-367-2738
Mailing Address - Fax:
Practice Address - Street 1:6136 N SELLAND AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-1553
Practice Address - Country:US
Practice Address - Phone:559-367-2738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18220390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program