Kim Elaine Hernandez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT2323 Issued in CA

Practice address

18655 W Bernardo Dr
San Diego, CA 92127-3002

Phone

(858) 579-1859

NPI assigned

Nov 20, 2012

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

Other names 1

• Kim Elaine Palmer Former 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": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1396089959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18216 MIRASOL DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921281226",
            "telephone_number": "858-864-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18655 W BERNARDO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273002",
            "telephone_number": "858-579-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "KIM",
        "middle_name": "ELAINE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT2323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "PALMER",
            "middle_name": "ELAINE",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Juan Hernandez
• Kallisto Hernandez
• Karla Camila Hernandez
• Katherine N Hernandez
• Kelly Hernandez
• Kristin Lynn Hernandez, LCSW
• Lauren Olympia Hernandez
• Lilia Ein Hernandez
• Lisette Hernandez
• Lourdes Hernandez

• Physical Therapy Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.