Mary Amanda Hernandez, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP36192 Issued in CA

Practice address

3636 Camino del Rio N Ste 101
San Diego, CA 92108-1722

Phone

(619) 928-1293

Fax

(619) 923-7522

NPI assigned

Aug 9, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Life Cycle Speech Therapy Corporation

  dba Life Cycle Speech Therapy

  • Speech-Language Pathologist
  • San Diego, CA
  • NPI 1275381600
  NPD

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1255014858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 ROBINSON AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034505",
            "telephone_number": "949-534-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 CAMINO DEL RIO N STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081722",
            "telephone_number": "619-928-1293",
            "fax_number": "619-923-7522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1607 Robinson Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921034505",
            "country_code": "US",
            "telephone_number": "949-534-5270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARY",
        "middle_name": "AMANDA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP36192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maricela Hernandez
• Marisol Corona Hernandez, DO, MPH
• Marissa Janette Hernandez, MS, CCC-SLP
• Marnel Reina Mae Manzano Hernandez, RN
• Martha Yahaira Hernandez
• Melinda Cecelia Hernandez
• Melissa Hernandez, TRAINEE
• Melissa Mahalia Hernandez
• Mia Hernandez
• Michael Angelo Hernandez, LMSW, ASW

• Speech-Language Pathologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.