Jonathan Antonio Hernandez
Individual provider Active NPI Behavior Technician · Ladera Ranch, CA
NPI 1083258693 · NPPES record last updated Nov 6, 2019
Key facts
- NPI
- 1083258693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- Y3058092 (CA)
- Practice address
- 600 Corporate Dr Ste 110
Ladera Ranch, CA 92694-2107 - Phone
- (949) 661-6753
- NPI assigned
- Nov 6, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| Y3058092 | CA | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Y3058092 | CA | Yes |
Addresses
Primary practice location
600 Corporate Dr Ste 110
Ladera Ranch, CA 92694-2107
Mailing address
600 Corporate Dr Ste 110
Ladera Ranch, CA 92694-2107
Other providers in Ladera Ranch, CA
- Courtney Allard
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- Maria Andruzzi Ambrosini
- American Cardio Labs
- Anchoring Hope
- Mohamad S.K. Arkee
- Azita S. Ebrahimi DDS Inc
- Badii Lee Dental Corporation, Inc
- Badii Orthodontics, Inc
- Maher M Badir
All providers in Ladera Ranch, CA · Behavior Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.