Individual provider Active NPI

Lucila R Hernandez, NP

  • Family Nurse Practitioner
  • West Covina, CA
National Provider Identifier
1881110567
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95007669 Issued in CA
Practice address
1135 S Sunset Ave Ste 401
West Covina, CA 91790-3921
Phone
(626) 732-8390
NPI assigned
Aug 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95007669 CA Primary

Addresses

Primary practice location

1135 S Sunset Ave Ste 401
West Covina, CA 91790-3921

Mailing address

PO Box 4039
Orange, CA 92863-4039
Phone (626) 543-1096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190104000801 CA Practitioner - Nurse Practitioner 7810233368 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95007669CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Care Foundation CurrentSince Jan 1, 2024 Accepting new patients
Emanate Health Medical Group Past Accepting new patients

Locations

1041 W Badillo St
Ste 104
Covina, CA 91722
Phone (626) 732-4168

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

440 W Foothill Blvd
Glendora, CA 91741
Phone (626) 963-9402

1135 S Sunset Ave
Ste 401
West Covina, CA 91790
Phone (626) 732-8390

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1881110567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4039",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928634039",
            "telephone_number": "626-543-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE STE 401",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903921",
            "telephone_number": "626-732-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "LUCILA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95007669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.