Patricia Y Hernandez, HAIR LOSS SPECIALIST

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

License

KK275336 Issued in CA

Practice address

3154 Winlow St
San Diego, CA 92105-3725

Phone

(619) 316-5028

NPI assigned

May 20, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Tricia Hernandez Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1194399493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3154 WINLOW ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921053725",
            "telephone_number": "619-316-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3154 WINLOW ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921053725",
            "telephone_number": "619-316-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "PATRICIA",
        "middle_name": "Y",
        "credential": "HAIR LOSS SPECIALIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "CA",
            "license": "KK275336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "HERNANDEZ",
            "credential": "HAIR LOSS SPECIALIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Moises Antonio Hernandez
• Nathalia C Hernandez
• Nina Marie Hernandez
• Noelia Maria Hernandez
• Ofelia Hernandez, APCC
• Priscilla Hernandez
• Ralph C. Hernandez, MD
• Ramon Hernandez
• Raquel Hernandez
• Raquel Hernandez

• Prosthetics Case Management in San Diego, CA
• Providers in San Diego, CA by specialty
• Prosthetics Case Management in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.