Individual provider Active NPI

Judy Hernandez Pedro, RN, MSN, PHN, CNS

  • School Registered Nurse
  • Bakersfield, CA
National Provider Identifier
1063776128
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN589688 Issued in CA
Practice address
1530 E 19TH St
Bakersfield, CA 93305-5406
Phone
(661) 631-5895
Fax
(661) 631-5898
NPI assigned
Jul 3, 2012
Last updated
Dec 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 589688 CA
School Registered Nurse 163WS0200X RN589688 CA Primary

Addresses

Primary practice location

1530 E 19TH St
Bakersfield, CA 93305-5406

Mailing address

1800 Mount Vernon Ave
Bakersfield, CA 93306-3302
Phone (661) 868-0502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Specialist, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
589688CAMDCommunity Health Registered Nurse
RN589688CAMDSchool Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1063776128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MOUNT VERNON AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933063302",
            "telephone_number": "661-868-0502",
            "fax_number": "661-868-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 E 19TH ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933055406",
            "telephone_number": "661-631-5895",
            "fax_number": "661-631-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRO",
        "first_name": "JUDY",
        "middle_name": "HERNANDEZ",
        "credential": "RN, MSN, PHN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "589688",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "RN589688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.