Individual provider Active NPI

Michelle Hernandez

  • Physical Therapist
  • West Covina, CA
National Provider Identifier
1346628468
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
36202 Issued in CA
Practice address
1616 S Grenoble Ave
West Covina, CA 91791-4042
Phone
(909) 263-8989
NPI assigned
May 8, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 36202 CA Primary

Addresses

Primary practice location

1616 S Grenoble Ave
West Covina, CA 91791-4042

Mailing address

1616 S Grenoble Ave
West Covina, CA 91791-4042
Phone (909) 263-8989

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

State licenses

LicenseStateTypeSpecialty
36202CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431043200000",
    "number": "1346628468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 S GRENOBLE AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917914042",
            "telephone_number": "909-263-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 S GRENOBLE AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917914042",
            "telephone_number": "909-263-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2015-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "36202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.