Jacob Giovanni Hernandez

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

302550 Issued in CA

Practice address

9051 Laurel Canyon Blvd SPC 50
Sun Valley, CA 91352-1766

Phone

(818) 641-0438

NPI assigned

Feb 13, 2021

Sex

Male

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

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

{
    "created_epoch": "1613174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1740873496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9051 LAUREL CANYON BLVD SPC 50",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913521766",
            "telephone_number": "818-641-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9051 LAUREL CANYON BLVD SPC 50",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913521766",
            "telephone_number": "818-641-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JACOB",
        "middle_name": "GIOVANNI",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-13",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "302550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrance Jonathan Brown Henson, RADT
• Heritage Hospice Services, Inc.
• Carlos Samuel Hernandez-Cervantes
• Danny Robert Hernandez, MSW
• Diana E Hernandez, LCSW
• Joseline Soriano Hernandez, RADT
• HHS Homecare, Inc
• Hichoice Health Care, Inc.
• Stephen E. Hiller, M.D.
• Mary Ann Hobbs, RADT

• Athletic Trainer in Sun Valley, CA
• Providers in Sun Valley, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2021; 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.