Julia Griselda Hernandez, CA LM 142, IBCLC
Individual provider Active NPI Midwife · Fairfax, CA
NPI 1649596255 · NPPES record last updated Apr 8, 2010
Key facts
- NPI
- 1649596255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- CA LM 142 (CA)
- Practice address
- 15 Valley Rd
Fairfax, CA 94930-1914 - Phone
- (415) 307-7251
- Fax
- (415) 453-8223
- NPI assigned
- Apr 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| CA LM 142 | CA | MD | Midwife |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | CA LM 142 | CA | Yes |
Addresses
Primary practice location
15 Valley Rd
Fairfax, CA 94930-1914
Mailing address
15 Valley Rd
Fairfax, CA 94930-1914
Phone (415) 307-7251
Other providers in Fairfax, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2010. 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.